Abstracts

Rationale: Cortical dysplasia leading to seizure is a major cause of medication refractory epilepsy.  Medication refractory epilepsy is especially debilitating due both to going seizures and the side effects of multiple AEDs.  Here we present preliminary data on the response to treatment with perampanel (Fycompa) in a population of known (by imaging) and suspected (by clinical history) patients with cortical malformations/dysplasia.     Methods: The subjects with suspected dysplasia did not have clear findings on a 3T MRI and were included based on age of onset, medication refractory seizures, catamenial seizure presence and supported by secondary history such as birth marks (tan) and birth order.  Results: Of the 41 subjects included in this study there was a 73% response rate with seizures being absent or significantly reduced in frequency or severity. Several of the subjects successfully reduced other AED use and a few were on monotherapy of perampanel.    Conclusions: This study shows a highly significant reduction in seizures with perampanel in this population.  The most common side effect reported was dizziness after taking the medication that lasted for 1-6 hours and increased in severity with increasing doses of drug.  Splitting the doses to BID reduced some of this side effect.  These results suggest that perampanel could be considered as a first-line treatment and alternative to traditional AEDs for medication refractory epilepsy.   Funding: University of Illinois, Carle Foundation Hospital.