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. 2022 Nov 2;19(1):54–60. doi: 10.1007/s13181-022-00915-1

Correction to: The Potential Proconvulsant Effects of Cannabis: a Scoping Review

Eric E Kaczor 1,✉, Kevin Greene 2, Jennifer Zacharia 3, Laura Tormoehlen 4, Mark Neavyn 3, Stephanie Carreiro 2
PMCID: PMC9813313  PMID: 36322377

Correction to : Journal of Medical Toxicology (2022) 18:223–234

https://doi.org/10.1007/s13181-022-00886-3

References #53 and #59 in this article contain errors. The correct references are as follows:

  • 53. Wang GS, Le Lait MC, Deakyne SJ, Bronstein AC, Bajaj L, Roosevelt G. Unintentional Pediatric Exposures to Marijuana in Colorado, 2009–2015. JAMA Pediatr. 2016;170(9):e160971.

  • 59. Onders B, Casavant MJ, Spiller HA, Chounthirath T, Smith GA. Marijuana Exposure Among Children Younger Than Six Years in the United States. Clin Pediatr (Phila). 2016;55(5):428–36.

In addition, the Table 1 citation numbering became mismatched during the final submission. The numbering has been updated to match the reference list.

Table 1.

Data Abstracted from Included Articles

Exposure Chronicity Author(s); Year, Type Study Goal/ Description Data Source Location Clinical Setting Timeframe Cohort Age Range (y) (Mean/Median), % Male, % Female Routes of Exposure Biomarker Testing Description of Cannabis Exposure Group Seizure Incidence (N); n = # of Cannabis Exposures (single: poly-substance) Other Relevant Findings/Takeaways
Acute Cannabis Exposures Anderson, et al. (57); 2019, RC Characterize neuropsychiatric presentation of cannabinoid exposures to the ED ToxIC Registry

U.S., 23 states

ED'10-'18

13–19 y

74% M, 26% F

 NR No Adolescents presenting to the ED for synthetic or traditional cannabis exposure 5.8% (5^);n = 348 (86: 262) SC-only & SC-polydrug exposures had higher rates of seizures than cannabis-only & cannabis-polydrug exposures, respectively
Heizer, et al. (49); 2018, RC Explore dose–response relationship in THC-naïve vs. non-naïve children after THC exposure Medical charts

CO, U.S., 1 hospital

Inpatient '09-'14

0—20 y (9.5 y)

60.5% M, 39.5% F

 Oral = 30 (39%), INH = 35 (46%), U/O = 11 (14%) Yes 2 Hospital presentations related to acute THC toxicity, excluding co-ingestions 3.9% (3^); n = 76 (76: 0) Clinical effects differed for naïve vs. non-naïve patients. Naïve patients exhibited more CNS effects & a direct relationship between dose ingested, hospital disposition & level of medical intervention required
Noble (52); 2019, RC Describe clinical effects of acute recreational cannabis exposures during early legalization period Oregon/ Alaska Poison Center

OR & AL, U.S

PCC '15-'17

0—96 y (20 y)

54.2% M, 45.8% F

 Oral = 187 (74%), INH = 57 (23%), U/O = 9 (3.6%) Yes 3 PCC calls for acute exposure to cannabis, excluding co-ingestions 3.6% (9^); n = 253 (253: 0)

Neurotoxicity is common after acute cannabis exposures

Concentrated products such as resins & liquid concentrates were associated with greater toxicity than other cannabis products
Onders, et al. (56); 2015, RC Provide information about pediatric exposures to MJ NPDS

U.S., 50 states

PCC '00-'13

0–6 y (1.81 y)

50.7% M, 49.3% F

 Oral = 1477 (75%), INH = 286 (14.5%), U/O = 206 (10.4%) NR All single substance MJ exposures involving children < 6 years old 0.51% (10^); n = 1,969 (1,969: 0) N/A

Schmid, et al. (51);

2020,

RC

 Characterize the acute toxicity of cannabis with & without co-substances Euro-DEN Plus

Switzerland, 3 hospitals

ED

'12-'18

14–68 y

(26 y)

77.4% M, 22.6% F

Oral = 40 (6%),

INH = 356 (50%), U/O = 321 (45%)

 Yes 4 ED presentations due to acute toxicity related to self-reported cannabis recreational use

4.8% (9^);

n = 717

(186: 531)

 No significant difference found in rate of seizures with cannabis alone vs. cannabis combined with other substances
Wang, et al. (53); 2016, RC Compare incidence of pediatric MJ exposures before & after recreational MJ legalization Medical charts

CO, U.S

PCC'09-'15

0–9 y (2 y)

48% M, 52% F

 Oral = 121 (74%), INH = 18 (11%), U/O = 24 (15%) Yes 5 ED/Urgent Care presentations, inpatient hospitalizations, & RPC cases for single-substance MJ exposures 3% (5^); n = 163 (163: 0) N/A
Wolfe, et al. (50); 2019, RC ID the recreational substances most implicated in seizures, their RR & differences in presentations with & without seizure Euro-DEN Plus

Europe, 21 countries

ED '14-'17

NR (31 y)

76% M, 23% F

 NR No ED presentations with acute recreational drug toxicity & self-reported cannabis use 3.1% (61^); n = 22,919 (1,954: 20,965)

Drugs associated with higher seizure incidence include fentanyl & synthetic cannabinoids

Heroin, clonazepam, & cannabis were associated with a lower seizure incidence than other drugs
Claudet, et al. (54); 2017, RC Assess characteristics of cannabis exposure in young children admitted from the ED Medical charts

France, 1 hospital

ED '04-'14

0–3 y (15.1 m)

NR

 Oral = 23 (79%), U/O = 6 (21%) Yes6 Children admitted to a pediatric ED due to unintentional cannabis exposure 14% (4); n = 29 (NR) N/A
Graham, et al. (58); 2020, RC Describe trends of illicit drug exposures in young children, their incidence & outcomes NPDS

U.S., 50 states

PCC '06-'16

0–10 y (2 y)

52% M, 48% F

 NR NR Pediatric exposure calls to all US Poison Centers that include acute cannabis exposure 2.3% (76); n = 3,365 (NR) N/A
Guidet, et al. (47); 2020, RC Present bio-concentrations of THC & metabolites in infants after cannabis intoxication Medical charts

France, 1 hospital

ED '16-'18

0–3 y (16 m)

20% M, 80% F

 Oral = 8 (80%), U/O = 2 (20%) Yes 1 ED presentations for cannabis poisoning with available data on [THC] & [metabolites] in plasma &/or urine 20% (2); n = 10 (10: 0) No correlation between plasma concentrations & symptoms, but [THC-COOH] in the 2 patients who experienced seizures was > 3000 (ng/mL)

Liakoni, et al. (55);

2015,

RC

 Describe the acute toxicity of recreational drugs Medical charts

Switzerland, 1 hospital

ED

'13-'14

 > 16 y

(31 y)

69% M,

31% F

 NR Yes7 ED presentations with acute toxicity due to self-reported recreational cannabis use

4.4% (3);

n = 68 (NR)

 N/A
Non-Acute Cannabis Exposures Desai, et al. (48); 2018, RC Assess the most frequently identified causes of hospitalization & independent predictors of in-hospital mortality in recreational MJ users NIS U.S., > 40 states Inpatient '10-'14

18–44 y (37 y)

63.2% M, 36.8% F

 NR NR All hospitalizations in patients with a history of recreational MJ usage *

1.8% (41,972) +; n = 465,959

(NR)

Hospital presentation for epilepsy among MJ users increased in recent years

Epilepsy & convulsions were the most common primary presentations at the time of MJ-related admission
Patel, et al. (60); 2019, RC Investigate the relationship between CUD & hospitalization for epilepsy NIS

U.S., > 40 states

Inpatient '10-'14

15–54 y

50.2% M, 49.8% F

 NR NR All hospitalizations with a primary diagnosis of epilepsy & an ICD-9 diagnosis of CUD 5.77% ϕ; n = 37,945 (NR) CUD is independently associated with a 56% increased likelihood of epilepsy hospitalization. Odds of epilepsy hospitalization were higher in cannabis, tobacco, & alcohol use disorders, but lower with cocaine, amphetamine, & opioid use disorders
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ToxIC Registry Toxicology Investigators Consortium Registry; NPDS National Poison Data System; Euro-DEN European Drug Emergencies Plus Network; NIS National Inpatient Sample; RC Retrospective Cohort; PC Prospective Cohort; SC Synthetic Cannabinoids; CUD Cannabis Use Disorder; RPC Regional Poison Center; UDS Urine Drug Screen; THC Tetrahydrocannabinol; MJ Marijuana; RR = Relative Risk; NR Not Reported; ID Identify; y Years; PCC Poison Center Calls; INH Inhaled; U/O Unknown or Other; N/A Not Applicable;

1only included cases with quantifiable serum &/or urine THC levels;

2Positive THC was part of inclusion criteria. Also used to rule out co-ingestions

323 (9%) had a positive UDS immunoassay;

4used in 54% (n = 387) of the cases; among these, THC was detected in 294/387 cases;

5Subjects were identified either by a positive UDS for THC or having one of a list of ICD-9 codes;

6UDS, positive in all;

783% confirmed with immunoassays & liquid chromatography/mass spectrometry (LC–MS/MS)

*only 13 subjects identified themselves as 'active cannabis users.'

+rate (n = total #) of admissions due to epilepsy in recreational cannabis users;

ϕCUD incidence in epilepsy patients

^seizure events (N) come from the single-substance ingestion group

[] concentration

The authors respectfully apologize for this error.

Footnotes

Publisher's Note

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References

  • 1.Bridgeman MB, Abazia DT. Medicinal Cannabis: History, Pharmacology, And Implications for the Acute Care Setting. Pharm Ther. 2017;42(3):180–188. [PMC free article] [PubMed] [Google Scholar]
  • 2.Barrus DG, Capogrossi KL, Cates SC, et al. Tasty THC: promises and challenges of cannabis edibles. Methods Rep RTI Press. 2016. 10.3768/rtipress.2016.op.0035.1611. [DOI] [PMC free article] [PubMed]
  • 3.Monte AA, Shelton SK, Mills E, Saben J, Hopkinson A, Sonn B, et al. Acute Illness Associated With Cannabis Use, by Route of Exposure. Ann Intern Med. 2019;170(8):531–537. doi: 10.7326/M18-2809. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Vandrey R, Raber JC, Raber ME, Douglass B, Miller C, Bonn-Miller MO. Cannabinoid Dose and Label Accuracy in Edible Medical Cannabis Products. JAMA. 2015;313(24):2491–2493. doi: 10.1001/jama.2015.6613. [DOI] [PubMed] [Google Scholar]
  • 5.Hammond D. Communicating THC levels and ‘dose’ to consumers: Implications for product labelling and packaging of cannabis products in regulated markets. Int J Drug Policy. 2021;91. [DOI] [PubMed]
  • 6.Freeman TP, Lorenzetti V. 'Standard THC units': a proposal to standardize dose across all cannabis products and methods of administration. Addiction. 2020;115(7):1207–1216. doi: 10.1111/add.14842. [DOI] [PubMed] [Google Scholar]
  • 7.Gounder K, Dunuwille J, Dunne J, Lee J, Silbert P, Lawn N. The other side of the leaf: Seizures associated with synthetic cannabinoid use. Epilepsy Behav. 2020;104(Pt A):106,901. doi: 10.1016/j.yebeh.2020.106901. [DOI] [PubMed] [Google Scholar]
  • 8.Kemp AM, Clark MS, Dobbs T, Galli R, Sherman J, Cox R. Top 10 Facts You Need to Know About Synthetic Cannabinoids: Not So Nice Spice. Am J Med. 2016;129(3):240–4e1. doi: 10.1016/j.amjmed.2015.10.008. [DOI] [PubMed] [Google Scholar]
  • 9.Lapoint JM. Cannabinoids. In: Nelson LS, Howland MA, Lewin NA, Smith SW, Goldfrank LR, Hoffman RS, editors. Goldfrank's Toxicologic Emergencies, 11e. New York, NY: McGraw-Hill Education; 2019. pp. 1111–1123. [Google Scholar]
  • 10.Spindle TR, Bonn-Miller MO, Vandrey R. Changing landscape of cannabis: novel products, formulations, and methods of administration. Curr Opin Psychol. 2019;30:98–102. doi: 10.1016/j.copsyc.2019.04.002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Espejo-Porras F, Fernández-Ruiz J, Pertwee RG, Mechoulam R, García C. Motor effects of the non-psychotropic phytocannabinoid cannabidiol that are mediated by 5-HT1A receptors. Neuropharmacology. 2013;75:155–163. doi: 10.1016/j.neuropharm.2013.07.024. [DOI] [PubMed] [Google Scholar]
  • 12.Morales P, Reggio PH. An Update on Non-CB1, Non-CB2 Cannabinoid Related G-Protein-Coupled Receptors. Cannabis and Cannabinoid Res. 2017;2(1):265–273. doi: 10.1089/can.2017.0036. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Navarro G, Varani K, Lillo A, Vincenzi F, Rivas-Santisteban R, Raïch I, et al. Pharmacological data of cannabidiol- and cannabigerol-type phytocannabinoids acting on cannabinoid CB1, CB2 and CB1/CB2 heteromer receptors. Pharmacol Res. 2020;159:104,940. doi: 10.1016/j.phrs.2020.104940. [DOI] [PubMed] [Google Scholar]
  • 14.Rosenthaler S, Pöhn B, Kolmanz C, Nguyen Huu C, Krewenka C, Huber A, et al. Differences in receptor binding affinity of several phytocannabinoids do not explain their effects on neural cell cultures. Neurotoxicol Teratol. 2014;46:49–56. doi: 10.1016/j.ntt.2014.09.003. [DOI] [PubMed] [Google Scholar]
  • 15.Le Boisselier R, Alexandre J, Lelong-Boulouard V, Debruyne D. Focus on cannabinoids and synthetic cannabinoids. Clin Pharmacol Ther. 2017;101(2):220–229. doi: 10.1002/cpt.563. [DOI] [PubMed] [Google Scholar]
  • 16.Abuhasira R, Shbiro L, Landschaft Y. Medical use of cannabis and cannabinoids containing products—Regulations in Europe and North America. Eur J Intern Med. 2018;49:2–6. doi: 10.1016/j.ejim.2018.01.001. [DOI] [PubMed] [Google Scholar]
  • 17.Zoorob MJ. The frequency distribution of reported THC concentrations of legal cannabis flower products increases discontinuously around the 20% THC threshold in Nevada and Washington state. J Cannabis Res. 2021;3(1):6. doi: 10.1186/s42238-021-00064-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 18.Barrus DG, Capogrossi KL, Cates SC, et al. Tasty THC: Promises and Challenges of Cannabis Edibles. Methods Rep RTI Press. 2016. 10.3768/rtipress.2016.op.0035.1611. [DOI] [PMC free article] [PubMed]
  • 19.Morrison PD, Murray RM. Cannabis points to the synaptic pathology of mental disorders: how aberrant synaptic components disrupt the highest psychological functions. Dialogues Clin Neurosci. 2020;22(3):251–258. doi: 10.31887/DCNS.2020.22.3/pmorrison. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey R. Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA. 2017;318(17):1708–1709. doi: 10.1001/jama.2017.11909. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Russo EB, McPartland JM. Cannabis is more than simply delta(9)-tetrahydrocannabinol. Psychopharmacology (Berl). 2003;165(4):431–2. doi: 10.1007/s00213-002-1348-z. [DOI] [PubMed] [Google Scholar]
  • 22.Russo EB. Taming THC: potential cannabis synergy and phytocannabinoid-terpenoid entourage effects. Br J Pharmacol. 2011;163(7):1344–1364. doi: 10.1111/j.1476-5381.2011.01238.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Burrows K, Williams JA. THC intoxication in a 16-month-old child. Paediatr Child Health. 2019;24(5):299–300. doi: 10.1093/pch/pxz015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Silliman Cohen R, Barron CE, Goldberg A. Altered Mental Status in a Young Child: A Case of Child Neglect. Clin Pediatr (Phila) 2019;58(1):123–125. doi: 10.1177/0009922818805225. [DOI] [PubMed] [Google Scholar]
  • 25.Carvalho A, Evans-Gilbert T. The Pathophysiology of Marijuana-induced Encephalopathy and Possible Epilepsy after Ingestion in Children: A Case Series. Innov Clin Neurosci. 2019;16(3–4):16–18. [PMC free article] [PubMed] [Google Scholar]
  • 26.Emoto J, Weeks K, Kallail KJ. Accidental Acute Cannabis Intoxication Presenting as Seizure in Pediatrics Patients. Kans J Med. 2020;13:129–130. doi: 10.17161/kjm.v13i1.13729. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27.Boadu O, Gombolay GY, Caviness VS, El Saleeby CM. Intoxication From Accidental Marijuana Ingestion in Pediatric Patients: What May Lie Ahead. Pediatr Emerg Care. 2020;36(6):e349–e354. doi: 10.1097/PEC.0000000000001420. [DOI] [PubMed] [Google Scholar]
  • 28.Bonkowsky JL, Sarco D, Pomeroy SL. Ataxia and shaking in a 2-year-old girl: acute marijuana intoxication presenting as seizure. Pediatr Emerg Care. 2005;21(8):527–528. doi: 10.1097/01.pec.0000173349.38024.33. [DOI] [PubMed] [Google Scholar]
  • 29.Richards JR, Smith NE, Moulin AK. Unintentional Cannabis Ingestion in Children: A Systematic Review. J Pediatr. 2017;190:142–152. doi: 10.1016/j.jpeds.2017.07.005. [DOI] [PubMed] [Google Scholar]
  • 30.Singh D, Huntwork M, Shetty V, Sequeira G, Akingbola O. Prolonged atrial fibrillation precipitated by new-onset seizures and marijuana abuse. Pediatrics. 2014;133(2):e443–e446. doi: 10.1542/peds.2013-1831. [DOI] [PubMed] [Google Scholar]
  • 31.Fogang YF, Camara M, Mbonda PC, Toffa D, Toure K. Late onset epilepsy associated with marijuana abuse: a case report with MRI findings. Pan Afr Med J. 2014;17:158. doi: 10.11604/pamj.2014.17.158.2402. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 32.Brust JC, Ng SK, Hauser AW, Susser M. Marijuana use and the risk of new onset seizures. Trans Am Clin Climatol Assoc. 1992;103:176–181. [PMC free article] [PubMed] [Google Scholar]
  • 33.Stockings E, Zagic D, Campbell G, Weier M, Hall WD, Nielsen S, et al. Evidence for cannabis and cannabinoids for epilepsy: a systematic review of controlled and observational evidence. J Neurol Neurosurg Psychiatry. 2018;89(7):741–753. doi: 10.1136/jnnp-2017-317168. [DOI] [PubMed] [Google Scholar]
  • 34.Meiri E, Jhangiani H, Vredenburgh JJ, Barbato LM, Carter FJ, Yang H-M, et al. Efficacy of dronabinol alone and in combination with ondansetron versus ondansetron alone for delayed chemotherapy-induced nausea and vomiting. Curr Med Res Opin. 2007;23(3):533–543. doi: 10.1185/030079907X167525. [DOI] [PubMed] [Google Scholar]
  • 35.May MB, Glode AE. Dronabinol for chemotherapy-induced nausea and vomiting unresponsive to antiemetics. Cancer Manag Res. 2016;8:49–55. doi: 10.2147/CMAR.S81425. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 36.Beal JE, Olson R, Laubenstein L, Morales JO, Bellman P, Yangco B, et al. Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. J Pain Symptom Manage. 1995;10(2):89–97. doi: 10.1016/0885-3924(94)00117-4. [DOI] [PubMed] [Google Scholar]
  • 37.Beal JE, Olson R, Lefkowitz L, Laubenstein L, Bellman P, Yangco B, et al. Long-term efficacy and safety of dronabinol for acquired immunodeficiency syndrome-associated anorexia. J Pain Symptom Manage. 1997;14(1):7–14. doi: 10.1016/S0885-3924(97)00038-9. [DOI] [PubMed] [Google Scholar]
  • 38.Rintala DH, Fiess RN, Tan G, Holmes SA, Bruel BM. Effect of dronabinol on central neuropathic pain after spinal cord injury: a pilot study. Am J Phys Med Rehabil. 2010;89(10):840–848. doi: 10.1097/PHM.0b013e3181f1c4ec. [DOI] [PubMed] [Google Scholar]
  • 39.Lofwall MR, Babalonis S, Nuzzo PA, Elayi SC, Walsh SL. Opioid withdrawal suppression efficacy of oral dronabinol in opioid dependent humans. Drug Alcohol Depend. 2016;164:143–150. doi: 10.1016/j.drugalcdep.2016.05.002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 40.Narang S, Gibson D, Wasan AD, Ross EL, Michna E, Nedeljkovic SS, et al. Efficacy of Dronabinol as an Adjuvant Treatment for Chronic Pain Patients on Opioid Therapy. J of Pain. 2008;9(3):254–264. doi: 10.1016/j.jpain.2007.10.018. [DOI] [PubMed] [Google Scholar]
  • 41.Lorenz R. On the application of cannabis in paediatrics and epileptology. Neuro Endocrinol Lett. 2004;25:40–44. [PubMed] [Google Scholar]
  • 42.Woodward MR, Harper DG, Stolyar A, Forester BP, Ellison JM. Dronabinol for the Treatment of Agitation and Aggressive Behavior in Acutely Hospitalized Severely Demented Patients with Noncognitive Behavioral Symptoms. Am J Geriatr Psychiatry. 2014;22(4):415–419. doi: 10.1016/j.jagp.2012.11.022. [DOI] [PubMed] [Google Scholar]
  • 43.Kuhlen M, Hoell JI, Gagnon G, Balzer S, Oommen PT, Borkhardt A, et al. Effective treatment of spasticity using dronabinol in pediatric palliative care. Eur J Paediatr Neurol. 2016;20(6):898–903. doi: 10.1016/j.ejpn.2016.07.021. [DOI] [PubMed] [Google Scholar]
  • 44.Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018;18(1):143. doi: 10.1186/s12874-018-0611-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 45.Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologies. Health Info Libr J. 2009;26(2):91–108. doi: 10.1111/j.1471-1842.2009.00848.x. [DOI] [PubMed] [Google Scholar]
  • 46.Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018;169(7):467–473. doi: 10.7326/M18-0850. [DOI] [PubMed] [Google Scholar]
  • 47.Guidet C, Gregoire M, Le Dreau A, Vrignaud B, Deslandes G, Monteil-Ganiere C. Cannabis intoxication after accidental ingestion in infants: urine and plasma concentrations of Delta-9-tetrahydrocannabinol (THC), THC-COOH and 11-OH-THC in 10 patients. Clin Toxicol (Phila) 2020;58(5):421–423. doi: 10.1080/15563650.2019.1655569. [DOI] [PubMed] [Google Scholar]
  • 48.Desai R, Shamim S, Patel K, Sadolikar A, Kaur VP, Bhivandkar S, et al. Primary Causes of Hospitalizations and Procedures, Predictors of In-hospital Mortality, and Trends in Cardiovascular and Cerebrovascular Events Among Recreational Marijuana Users: A Five-year Nationwide Inpatient Assessment in the United States. Cureus. 2018;10(8):e3195. doi: 10.7759/cureus.3195. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 49.Heizer JW, Borgelt LM, Bashqoy F, Wang GS, Reiter PD. Marijuana Misadventures in Children: Exploration of a Dose-Response Relationship and Summary of Clinical Effects and Outcomes. Pediatr Emerg Care. 2018;34(7):457–462. doi: 10.1097/PEC.0000000000000770. [DOI] [PubMed] [Google Scholar]
  • 50.Wolfe CE, Wood DM, Dines A, Whatley BP, Yates C, Heyerdahl F, et al. Seizures as a complication of recreational drug use: Analysis of the Euro-DEN Plus data-set. Neurotoxicology. 2019;73:183–187. doi: 10.1016/j.neuro.2019.04.003. [DOI] [PubMed] [Google Scholar]
  • 51.Schmid Y, Scholz I, Mueller L, Exadaktylos AK, Ceschi A, Liechti ME, et al. Emergency department presentations related to acute toxicity following recreational use of cannabis products in Switzerland. Drug Alcohol Depend. 2020;206:107726. doi: 10.1016/j.drugalcdep.2019.107726. [DOI] [PubMed] [Google Scholar]
  • 52.Noble MJ, Hedberg K, Hendrickson RG. Acute cannabis toxicity. Clin Toxicol (Phila) 2019;57(8):735–742. doi: 10.1080/15563650.2018.1548708. [DOI] [PubMed] [Google Scholar]
  • 53.Wang GS, Le Lait MC, Deakyne SJ, Bronstein AC, Bajaj L, Roosevelt G. Unintentional Pediatric Exposures to Marijuana in Colorado, 2009–2015. JAMA Pediatr. 2016;170(9):e160971. doi: 10.1001/jamapediatrics.2016.0971. [DOI] [PubMed] [Google Scholar]
  • 54.Claudet I, Le Breton M, Brehin C, Franchitto N. A 10-year review of cannabis exposure in children under 3-years of age: do we need a more global approach? Eur J Pediatr. 2017;176(4):553–556. doi: 10.1007/s00431-017-2872-5. [DOI] [PubMed] [Google Scholar]
  • 55.Liakoni E, Dolder PC, Rentsch K, Liechti ME. Acute health problems due to recreational drug use in patients presenting to an urban emergency department in Switzerland. Swiss Med Wkly. 2015;145:w14166. doi: 10.4414/smw.2015.14166. [DOI] [PubMed] [Google Scholar]
  • 56.Onders B, Casavant MJ, Spiller HA, Chounthirath T, Smith GA. Marijuana Exposure Among Children Younger Than Six Years in the United States. Clin Pediatr (Phila) 2016;55(5):428–436. doi: 10.1177/0009922815589912. [DOI] [PubMed] [Google Scholar]
  • 57.Anderson SAR, Oprescu AM, Calello DP, Monte A, Dayan PS, Hurd YL, et al. Neuropsychiatric Sequelae in Adolescents With Acute Synthetic Cannabinoid Toxicity. Pediatrics. 2019;144(2). [DOI] [PMC free article] [PubMed]
  • 58.Graham J, Leonard J, Banerji S, Wang GS. Illicit Drug Exposures in Young Pediatric Patients Reported to the National Poison Data System, 2006–2016. J Pediatr. 2020;219(254–8):e1. doi: 10.1016/j.jpeds.2019.11.004. [DOI] [PubMed] [Google Scholar]
  • 59.Onders B, Casavant MJ, Spiller HA, Chounthirath T, Smith GA. Marijuana Exposure Among Children Younger Than Six Years in the United States. Clin Pediatr (Phila) 2016;55(5):428–436. doi: 10.1177/0009922815589912. [DOI] [PubMed] [Google Scholar]
  • 60.Patel RS, Mekala HM, Tankersley WE. Cannabis Use Disorder and Epilepsy: A Cross-National Analysis of 657 072 Hospitalized Patients. Am J Addict. 2019;28(5):353–360. doi: 10.1111/ajad.12898. [DOI] [PubMed] [Google Scholar]
  • 61.Desai R, Patel U, Sharma S, Amin P, Bhuva R, Patel MS, et al. Recreational Marijuana Use and Acute Myocardial Infarction: Insights from Nationwide Inpatient Sample in the United States. Cureus. 2017;9(11):e1816. doi: 10.7759/cureus.1816. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 62.Huff JS, Morris DL, Kothari RU, Gibbs MA. Emergency Medicine Seizure Study G. Emergency department management of patients with seizures: a multicenter study. Acad Emerg Med. 2001;8(6):622–8. doi: 10.1111/j.1553-2712.2001.tb00175.x. [DOI] [PubMed] [Google Scholar]
  • 63.Krumholz A, Grufferman S, Orr ST, Stern BJ. Seizures and seizure care in an emergency department. Epilepsia. 1989;30(2):175–181. doi: 10.1111/j.1528-1157.1989.tb05451.x. [DOI] [PubMed] [Google Scholar]
  • 64.Pallin DJ, Goldstein JN, Moussally JS, Pelletier AJ, Green AR, Camargo CA., Jr Seizure visits in US emergency departments: epidemiology and potential disparities in care. Int J Emerg Med. 2008;1(2):97–105. doi: 10.1007/s12245-008-0024-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 65.Schoenenberger RA, Heim SM. Indication for computed tomography of the brain in patients with first uncomplicated generalised seizure. BMJ. 1994;309(6960):986–989. doi: 10.1136/bmj.309.6960.986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 66.Zack MM, Kobau R. National and State Estimates of the Numbers of Adults and Children with Active Epilepsy - United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;66(31):821–825. doi: 10.15585/mmwr.mm6631a1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 67.Fiest KM, Sauro KM, Wiebe S, Patten SB, Kwon CS, Dykeman J, et al. Prevalence and incidence of epilepsy: A systematic review and meta-analysis of international studies. Neurology. 2017;88(3):296–303. doi: 10.1212/WNL.0000000000003509. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 68.Camfield P, Camfield C. Incidence, prevalence and aetiology of seizures and epilepsy in children. Epileptic Disord. 2015;17(2):117–123. doi: 10.1684/epd.2015.0736. [DOI] [PubMed] [Google Scholar]
  • 69.ElSohly MA, Ross SA, Mehmedic Z, Arafat R, Yi B, Banahan BF., 3rd Potency trends of delta9-THC and other cannabinoids in confiscated marijuana from 1980–1997. J Forensic Sci. 2000;45(1):24–30. doi: 10.1520/JFS14636J. [DOI] [PubMed] [Google Scholar]
  • 70.Stambouli H, El Bouri A, Bouayoun T. Évolution de la teneur en Δ9-THC dans les saisies de résines de cannabis au Maroc de 2005 à 2014. Toxicologie Analytique et Clinique. 2016;28(2):146–152. doi: 10.1016/j.toxac.2015.11.001. [DOI] [Google Scholar]
  • 71.Ham MT, Loskota WJ, Lomax P. Acute and chronic effects of Δ9-tetrahydrocannabinol on seizures in the gerbil. Euro J Pharmacol. 1975;31(1):148–152. doi: 10.1016/0014-2999(75)90087-4. [DOI] [PubMed] [Google Scholar]
  • 72.Consroe P, Martin AR, Fish BS. Use of a potential rabbit model for structure–behavioral activity studies of cannabinoids. J Med Chem. 1982;25(5):596–599. doi: 10.1021/jm00347a021. [DOI] [PubMed] [Google Scholar]
  • 73.Johnson DD, McNeill JR, Crawford RD, Wilcox WC. Epileptiform seizures in domestic fowl. V. The anticonvulsant activity of Δ9-tetrahydrocannabinol. Can J Physiol Pharmacol. 1975;53(6):1007–13. doi: 10.1139/y75-140. [DOI] [PubMed] [Google Scholar]
  • 74.Chiu P, Olsen DM, Borys HK, Karler R, Turkanis SA. The influence of cannabidiol and delta 9-tetrahydrocannabinol on cobalt epilepsy in rats. Epilepsia. 1979;20(4):365–375. doi: 10.1111/j.1528-1157.1979.tb04816.x. [DOI] [PubMed] [Google Scholar]
  • 75.Colasanti BK, Lindamood C, 3rd, Craig CR. Effects of marihuana cannabinoids on seizure activity in cobalt-epileptic rats. Pharmacol Biochem Behav. 1982;16(4):573–578. doi: 10.1016/0091-3057(82)90418-X. [DOI] [PubMed] [Google Scholar]
  • 76.Turkanis SA, Karler R. Central excitatory properties of Δ9-tetrahydrocannabinol and its metabolites in iron-induced epileptic rats. Neuropharmacology. 1982;21(1):7–13. doi: 10.1016/0028-3908(82)90204-0. [DOI] [PubMed] [Google Scholar]
  • 77.Karler R, Calder L, Sangdee P, Turkanis S. Interaction between delta-9-tetrahydro-cannabinol and kindling by electrical and chemical stimuli in mice. Neuropharmacology. 1984;23(11):1315–1320. doi: 10.1016/0028-3908(84)90052-2. [DOI] [PubMed] [Google Scholar]
  • 78.Turkanis SA, Karler R. Electrophysiologic properties of the cannabinoids. J Clin Pharmacol. 1981;21(S1):449S–S463. doi: 10.1002/j.1552-4604.1981.tb02625.x. [DOI] [PubMed] [Google Scholar]
  • 79.Wada JA, Wake A, Sato M, Corcoran ME. Antiepileptic and prophylactic effects of tetrahydrocannabinols in amygdaloid kindled cats. Epilepsia. 1975;16(3):503–510. doi: 10.1111/j.1528-1157.1975.tb06080.x. [DOI] [PubMed] [Google Scholar]
  • 80.Sofia RD, Solomon TA, Barry H., 3rd Anticonvulsant activity of delta9-tetrahydrocannabinol compared with three other drugs. Eur J Pharmacol. 1976;35(1):7–16. doi: 10.1016/0014-2999(76)90295-8. [DOI] [PubMed] [Google Scholar]
  • 81.Culler CA, Vigani A. Successful treatment of a severe cannabinoid toxicity using extracorporeal therapy in a dog. J Vet Emerg Crit Care (San Antonio) 2019;29(6):674–679. doi: 10.1111/vec.12899. [DOI] [PubMed] [Google Scholar]
  • 82.Girling SJ, Fraser MA. Cannabis intoxication in three Green iguanas (Iguana iguana) J Small Anim Pract. 2011;52(2):113–116. doi: 10.1111/j.1748-5827.2010.01017.x. [DOI] [PubMed] [Google Scholar]
  • 83.Brutlag A, Hommerding H. Toxicology of Marijuana, Synthetic Cannabinoids, and Cannabidiol in Dogs and Cats. Vet Clin North Am Small Anim Pract. 2018;48(6):1087–1102. doi: 10.1016/j.cvsm.2018.07.008. [DOI] [PubMed] [Google Scholar]
  • 84.Breivogel CS, Wells JR, Jonas A, Mistry AH, Gravley ML, Patel RM, et al. Comparison of the Neurotoxic and Seizure-Inducing Effects of Synthetic and Endogenous Cannabinoids with Delta(9)-Tetrahydrocannabinol. Cannabis Cannabinoid Res. 2020;5(1):32–41. doi: 10.1089/can.2019.0003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 85.Malyshevskaya O, Aritake K, Kaushik MK, Uchiyama N, Cherasse Y, Kikura-Hanajiri R, et al. Natural ((9)-THC) and synthetic (JWH-018) cannabinoids induce seizures by acting through the cannabinoid CB1 receptor. Sci Rep. 2017;7(1):10516. doi: 10.1038/s41598-017-10447-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 86.Whalley BJ, Lin H, Bell L, Hill T, Patel A, Gray RA, et al. Species-specific susceptibility to cannabis-induced convulsions. Br J Pharmacol. 2019;176(10):1506–1523. doi: 10.1111/bph.14165. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 87.Kaczor EE, Mathews B, LaBarge K, Chapman BP, Carreiro S. Cannabis Product Ingestions in Pediatric Patients: Ranges of Exposure, Effects, and Outcomes. J Med Toxicol. 2021;17(4):386–396. doi: 10.1007/s13181-021-00849-0. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 88.Fedak KM, Bernal A, Capshaw ZA, Gross S. Applying the Bradford Hill criteria in the 21st century: how data integration has changed causal inference in molecular epidemiology. Emerg Themes Epidemiol. 2015;12(1):14. doi: 10.1186/s12982-015-0037-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 89.Kreitzer AC. Neurotransmission: emerging roles of endocannabinoids. Curr Biol. 2005;15(14):R549–R551. doi: 10.1016/j.cub.2005.07.005. [DOI] [PubMed] [Google Scholar]
  • 90.Katona I, Freund TF. Endocannabinoid signaling as a synaptic circuit breaker in neurological disease. Nat Med. 2008;14(9):923–930. doi: 10.1038/nm.f.1869. [DOI] [PubMed] [Google Scholar]
  • 91.Wiley JL, Lefever TW, Marusich JA, Grabenauer M, Moore KN, Huffman JW, et al. Evaluation of first generation synthetic cannabinoids on binding at non-cannabinoid receptors and in a battery of in vivo assays in mice. Neuropharmacology. 2016;110:143–153. doi: 10.1016/j.neuropharm.2016.07.016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 92.Schneir AB, Baumbacher T. Convulsions associated with the use of a synthetic cannabinoid product. J Med Toxicol. 2012;8(1):62–64. doi: 10.1007/s13181-011-0182-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 93.Funada M, Takebayashi-Ohsawa M. Synthetic cannabinoid AM2201 induces seizures: Involvement of cannabinoid CB1 receptors and glutamatergic transmission. Toxicol Appl Pharmacol. 2018;338:1–8. doi: 10.1016/j.taap.2017.10.007. [DOI] [PubMed] [Google Scholar]
  • 94.Chen HY, Albertson TE, Olson KR. Treatment of drug-induced seizures. Br J Clin Pharmacol. 2016;81(3):412–419. doi: 10.1111/bcp.12720. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 95.Holtkamp M. Pharmacotherapy for Refractory and Super-Refractory Status Epilepticus in Adults. Drugs. 2018;78(3):307–326. doi: 10.1007/s40265-017-0859-1. [DOI] [PubMed] [Google Scholar]
  • 96.Thomas AA, Dickerson-Young T, Mazor S. Unintentional Pediatric Marijuana Exposures at a Tertiary Care Children's Hospital in Washington State: A Retrospective Review. Pediatr Emerg Care. 2021;37(10):e594–e598. doi: 10.1097/PEC.0000000000001703. [DOI] [PubMed] [Google Scholar]
  • 97.Thomas AA, Mazor S. Unintentional Marijuana Exposure Presenting as Altered Mental Status in the Pediatric Emergency Department: A Case Series. J Emerg Med. 2017;53(6):e119–e123. doi: 10.1016/j.jemermed.2017.08.007. [DOI] [PubMed] [Google Scholar]
  • 98.Toce MS, Farias M, Powell AJ, Daly KP, Vargas SO, Burns MM. Myocardial Infarct After Marijuana Inhalation in a 16-year-old Adolescent Boy. Pediatr Dev Pathol. 2019;22(1):80–86. doi: 10.1177/1093526618785552. [DOI] [PubMed] [Google Scholar]
  • 99.Wadhwa A, Bal S, Imoukhuede O, Doshi D. Shattering the Carotids. Stroke. 2021;52(5):e160–e163. doi: 10.1161/STROKEAHA.120.032428. [DOI] [PubMed] [Google Scholar]

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