Date of Award


Document Type

Restricted Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)


Physician Assistant Studies

First Advisor

Vanessa Bester


Refractory epilepsy is characterized by frequent seizures not responsive to standard anti-epileptic medications. Patients with refractory epilepsy are diagnosed earlier in life-a time crucial for brain development- that can lead to developmental delays, neurocognitive impairments, and psychological disorders. Anti-epileptic medications and the ketogenic diet have been the long-time standard of treatment for this patient population. Antiepileptic medications have life threatening side effects, are not well-tolerated, require close patient follow-up, and have a low degree of efficacy which makes it difficult for patients to be fully compliant with their treatment. Studies show better seizure control with combined treatment of the ketogenic diet and AEDs than with AEDs alone. Long-term treatment using the ketogenic diet remains impractical for most patients due to its strict diet plan to keep the body in a state of ketosis. The legalization of medicinal cannabidiol (CBD) has led to the discovery of its anti-epileptic properties. The growing research of CBD as an adjuvant therapy in refractory epilepsies has shown to be safer, better tolerated, and produce a better outcome for patients with refractory epilepsy. Although CBD is not FDA approved, studies are discovering the significant role it play in reducing seizure frequency, AED side effects, and improving the overall quality of life for patients and their families. More formal studies using a standardized cannabidiol preparation will be necessary to determine specifics such as optimal and safe dosing, long-term effects, and tolerance with chronic use.