Treatment of pharmacoresistant sleep-related hypermotor epilepsy (SHE) with the selective AMPA receptor antagonist perampanel

Sleep Med. 2021 May:81:382-386. doi: 10.1016/j.sleep.2020.12.020. Epub 2021 Apr 5.

Abstract

This study aimed to evaluate the efficacy and tolerability of perampanel (PER) as adjunctive therapy in patients with pharmacoresistant sleep-related hypermotor epilepsy (SHE). Patients diagnosed with SHE who received PER treatment between 2016 and 2019 were included, and their data were reviewed retrospectively. Diagnosis was based on reports of patients or family members witnessing the events and clinical characteristics of seizures captured by video or during video-electroencephalography monitoring. Among 36 SHE patients, 20 with pharmacoresistant SHE (six female; mean age: 34.1 ± 9.0 years) who received PER as adjunctive therapy were included in this study. Fourteen out of the 20 patients received PER with mean length of PER exposure of 24.6 ± 15.7 months: 10 of them were responders and four non-responders. The remaining six patients discontinued PER for adverse events (n = 5) and patient choice (n = 1). Among the 10 responders, six (60%) reported seizure-free periods lasting ≥6 months. The most common PER-associated adverse event was dizziness (25%) followed by malaise (10%). Clinical experience with these patients demonstrated that PER might be considered as an add-on anti-seizure medication for patients with highly pharmacoresistant SHE.

Keywords: Anti-seizure medication; Nocturnal frontal lobe epilepsy; Perampanel; Sleep-related hypermotor epilepsy.

MeSH terms

  • Adult
  • Anticonvulsants / therapeutic use
  • Epilepsy* / drug therapy
  • Female
  • Humans
  • Male
  • Nitriles
  • Pyridones / therapeutic use*
  • Receptors, AMPA / antagonists & inhibitors*
  • Retrospective Studies
  • Sleep*
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Nitriles
  • Pyridones
  • Receptors, AMPA
  • perampanel