Abstracts

Rationale: We describe the electroclinical evolution of adjuvant treatment with perampanel (PER) in patients with juvenile myoclonic epilepsy (JME) at 12 months, evaluating their response both at clinical level and their generalized epileptiform activity of the electroencephalogram (EEG). Methods: This is a unicentric, observational, open and non-interventional study. For the EEG analysis, there were analyzed the number and duration of the generalized discharges (GDs) in the EEG registries performed for 45 minutes at the same time of day and under same patient's conditions. Results: The sample included 21 patients with juvenile myoclonic epilepsy (JME). Before PER treatment, the mean total generalized seizures in the previous 3 months was 11.9 seizures: 5 patients with absences; 11 patients with myoclonus and 8 patients presented tonic-clonic seizures. The most common concomitant antiepileptic drug (AED) was Levetiracetam (LEV). Before treatment with PER, 3 patients had a normal EEG and 18 patients had an EEG with generalized activity. At 12-month follow-up the mean dose of PER was 4.6 mg / day and the titration schedule was 2 mg every two weeks. At 12 months of adjuvant treatment with PER, all patients were responders to the treatment and 85 % of patients were seizure free for all primary generalized seizures (tonic-clonic, myoclonic and absence seizures). After 1 year of adjuvant treatment with PER, absences were totally controlled in all patients, two patients continued with myoclonic seizures and only one patient described tonic-clonic seizures.After 1 year of follow-up, treatment with PER continued in 20 of 21 patients (retention rate: 95.2%). 15 patients (71.4%) did not present any adverse effects during the entire follow-up. The most common adverse effects were irritability (19%) and dizziness (9.5%), most of which were classified as mild or moderate. EEG data after one year of adjuvant treatment with PER showed normalization in 10 patients (47.6%) and no patients showed a worsening of their EEG. 3 patients presented normal EEG at the onset and the EEG of this patients remained normal by the end of the follow-up. The median number and the duration of GDs was statistically significant reduced at 12 months (p<0.001). Conclusions: PER is shown as a safe and effective AED as adjuvant treatment for juvenile myoclonic epilepsy in clinical practice, being confirmed as a broad-spectrum AED. Its high effectiveness in the seizure control in this subtype of epilepsy suggest the possibility of its use as first choice AED. Funding: No funding