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August 01, 2007

More Supreme Ignorance

Although I thought I was inured to the amount of spin routinely applied to news in this country, I was dumbfounded by the optimism expressed in the initial reports that our newly appointed Chief Justice had suffered a repeat seizure while vacationing in Maine. Let’s just say that I had never seen the word “benign” thrown around quite so liberally and inappropriately in any description of a potentially serious medical problem at such an early a stage.
Finally, today’s NYT item raised some of the common-sense cautions that any competent physician should have been able to come up with upon hearing that an otherwise healthy fifty-two year old male had sustained his second grand mal seizure in 14 years. Certainly the issue of prophylactic treatment with anticonvulants is important for two reasons: first, the real danger inherent in repeat episodes and second, a fact  the Times article makes reasonably clear: there is no completely benign and effective  prophylactic anticonvulsant regimen which is also well tolerated by even a majority of candidates.

One thing sure to not be reported in any newspaper is that marijuana seems to be an effective and well tolerated anticonvulsant. I was relatively unfamilar with that fact until I began taking histories from pot smokers and encountered several with convincing histories similar to one posted on the web: they were patients in whom standard regimens were either failng to prevent seizures or had produced intolerable side effects, who have been seizure free on pot for extended intervals. Of course, they had discovered that as a result of their chronic illegal use which they had previously considered "recreational."

As for the Chief Justice, who recently authored a sweeping Bong Hits decision that surprised very few, but pleased even fewer, he would presumeably reject such "anecdotal" evidence out of hand and agree with NIDA that any such reports are unworthy of “serious” research (whatever that is).

Doctor Tom

Posted by tjeffo at August 1, 2007 09:42 PM