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Retrospective study of perampanel efficacy and tolerability in myoclonic seizures
Author(s) -
GilLópez F. J.,
Montoya J.,
Falip M.,
Aparicio J.,
LópezGonzález F. J.,
Toledano R.,
GilNagel A.,
Molins A.,
García I.,
Serrano P.,
Domenech G.,
Torres F.,
Donaire A.,
Carreño M.
Publication year - 2018
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12931
Subject(s) - perampanel , tolerability , medicine , epilepsy , pediatrics , anesthesia , juvenile myoclonic epilepsy , irritability , progressive myoclonus epilepsy , retrospective cohort study , myoclonus , adverse effect , psychiatry , cognition
Objectives Perampanel is an antiepileptic drug ( AED ) approved for add‐on treatment of focal seizures (with or without generalization) and primary generalized tonic‐clonic ( GTC ) seizures. Our objective was to explore the effectiveness and tolerability of adjunctive perampanel in patients with drug‐resistant myoclonic seizures, after failure of other AED s. Materials and methods Retrospective, multicenter, observational study. Data were collected from individual patient clinical files and analysed using appropriate descriptive statistics and inferential analyses. Results Data are reported for 31 patients with mean age 36.4 years, who had an average epilepsy duration of 18 years, previously taken an average of 5.03 AED s, and were taking an average of 2.4 AED s on perampanel initiation. Patients exhibited myoclonic, GTC , absence, tonic and focal seizures, and most had associated cognitive decline and/or ataxia. Median time on perampanel was 6 months, most common dose was 6 mg, and overall retention rate was 84%. The responder rate for myoclonic seizures was defined via reduction of days with myoclonic seizures per month. At 6 months, 15 (48.4%) of the 31 patients were classed as myoclonic seizure responders, 10 (32.3%) were myoclonic seizure free, and 39% saw improvements in functional ability. Of 17 patients with GTC seizures at baseline, 9 (53%) were responders at 6 months, and 8 (47.1%) were seizure free. The most frequent side effects were psychiatric disorders, instability, dizziness and irritability, and mostly resolved with dose reduction. Five patients discontinued perampanel due to side effects. Conclusions Perampanel caused clinically meaningful improvements in patients with drug‐resistant myoclonic seizures. It was generally well tolerated, but psychiatric and neurological side effects sometimes required follow‐up and dose reduction.