Abstracts

Rationale: Perampanel is a non-competitive AMPA receptor antagonist that has shown broad-spectrum anticonvulsant activity. It is approved as an adjunctive therapy for primary generalized tonic-clonic seizures in patients with Idiopathic Generalized Epilepsy (IGE). Our aim was to analyze the effectiveness of add-on PER treatment in refractory IGE. Methods: We studied patients with clear-cut electroclinical IGE syndromes refractory to previous standard polytherapy. We analyzed effectiveness, adverse events, retention rate and EEG pre- and post-perampanel frequency of epileptiform discharges during sleep and awakening. Results: 10 patients (8 Females). Median age: 26.8 years (18-59). Age at onset: 12 (5-16). Follow-up from the onset of perampanel: 16,5 months (3-22). Perampanel dose range: 2-8 mg/day. Seizure types: Tonic-Clonic: 10; absences + tonic-clonic: 5; myoclonic + tonic-clonic: 3; absences + myoclonic + tonic-clonic: 1. Epileptic syndromes: Childhood absence: 3; Juvenile absence: 3; Juvenile Myoclonic: 3; Tonic-Clonic only: 1. Mean previous drugs: 4,4 (3-7). Efficacy: Seizure-free: 2 (one with juvenile myoclonic epilepsy and one with tonic-clonic seizures only); >50 % baseline seizure reduction: 4(two with childhood absences, one with juvenile absences and one with juvenile myoclonic epilepsy); no change: 3; and, increased seizure frequency: 1. Adverse events: somnolence: 2; behavioral changes: 1 (1 patient discontinued perampanel due to adverse events). Retention at the end of follow-up: 60%. We considered a good association between clinical and EEG findings in 60%. Conclusions: Perampanel can be effective in patients with refractory IGE, particularly in patients with myoclonic and absence seizures, with relatively good tolerability and retention rate after one year of follow-up. Funding: This study has been granted by EISAI Laboratories.