Effectiveness and tolerability of perampanel in children and adolescents with refractory epilepsies: first experiences.
OBJECTIVE
This article aims to report the first clinical experiences concerning effectiveness and tolerability of perampanel (PER) in a pediatric population with refractory epilepsies.


METHODS
This nonsponsored, observational, retrospective survey was conducted through collaboration with multiple centers in Europe. The clinical course of the first pediatric patients treated in these centers with PER was documented with the help of a questionnaire completed by the treating physicians. Effectiveness and adverse effects were evaluated. The study population consisted of 58 patients (mean age, 10.5 years; range, 2-17 years), suffering from various refractory epilepsies, classified as focal epilepsy (n = 36), unclassified generalized epilepsy (n = 12), Lennox-Gastaut syndrome (n = 5), West syndrome (n = 3), and Dravet syndrome (n = 2).


RESULTS
The response rate (≥ 50% seizure reduction) after the first 3 months of therapy was 31% (18/58 patients) in total. Complete seizure control was achieved in five patients (9% overall). Aggravation of seizures occurred in five cases (9%). The most frequently occurring adverse effects were reduced vigilance or fatigue (n = 16) and behavioral changes (n = 14).


CONCLUSIONS
PER seems to be effective also in children and adolescents with pharmaco-refractory epilepsies. Tolerability was acceptable.
Department of Pediatric Neurology and Neurological Rehabilitation, Schön Klinik Vogtareuth, Vogtareuth, Germany.
Anna
A
Biró
Department of Neuropediatrics, Christian-Albrechts University, University Medical Center Schleswig-Holstein, Kiel, Germany.
Ulrich
U
Stephani
Department of Neuropediatrics, Christian-Albrechts University, University Medical Center Schleswig-Holstein, Kiel, Germany.
Tiziana
T
Tarallo
Epilepsy Center Kork, Kehl, Germany.
Thomas
T
Bast
Department of Pediatrics, Bregenz Regional Hospital, Bregenz, Austria.
Kurt
K
Schlachter
Department of Pediatrics, Bregenz Regional Hospital, Bregenz, Austria.
Martin
M
Fleger
Department of Neuropediatrics, University Children's Hospital Münster, Münster, Germany.
Gerhard
G
Kurlemann
Department of Neuropediatrics, University Children's Hospital Münster, Münster, Germany.
Barbara
B
Fiedler
Department of Pediatrics, Dritter Orden Clinic, München, Germany.
Steffen
S
Leiz
Children's Department, Danish Epilepsy Centre, Dianalund, Denmark.
Marina
M
Nikanorova
Department of Pediatric Neurology, University Children's Hospital Tübingen, Tübingen, Germany.
Markus
M
Wolff
Department of Pediatric Neurology and Neurological Rehabilitation, Schön Klinik Vogtareuth, Vogtareuth, Germany.
Arnd
A
Müller
Department of Pediatric Neurology and Neurological Rehabilitation, Schön Klinik Vogtareuth, Vogtareuth, Germany.
Christina
C
Selch
Department of Pediatric Neurology and Neurological Rehabilitation, Schön Klinik Vogtareuth, Vogtareuth, Germany.
Martin
M
Staudt
Department of Pediatric Neurology and Neurological Rehabilitation, Schön Klinik Vogtareuth, Vogtareuth, Germany.
Gerhard
G
Kluger
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D009570:Nitriles; D011728:Pyridones / Q000009:adverse effects / Q000627:therapeutic use*; D018091:Receptors, AMPA / Q000037:antagonists & inhibitors; D012189:Retrospective Studies; D016896:Treatment Outcome
D009570:Nitriles; D011728:Pyridones; D018091:Receptors, AMPA; C551441:perampanel