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Retrospective study of perampanel efficacy and tolerability in myoclonic seizures.

Abstract：

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 AEDs. 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 AEDs, and were taking an average of 2.4 AEDs 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.

journal_name

Acta Neurol Scand

journal_title

Acta neurologica Scandinavica

authors

Gil-López FJ,Montoya J,Falip M,Aparicio J,López-González FJ,Toledano R,Gil-Nagel A,Molins A,García I,Serrano P,Domenech G,Torres F,Donaire A,Carreño M

doi

10.1111/ane.12931

subject

Has Abstract

pub_date

2018-08-01 00:00:00

pages

122-129

issue

eissn

0001-6314

issn

1600-0404

journal_volume

138

pub_type

杂志文章,多中心研究

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Retrospective study of perampanel efficacy and tolerability in myoclonic seizures.