A 4-year-old boy without perinatal asphyxia and familial history of epilepsy began to have ictal seizures from age 14 month, with jerky movement of four limbs and head nodding. Abnormal multifocal discharge and background activity were recorded through electroencephalography, and no pathogenic mutation was found in the whole exome sequencing for the patient and his parents. He had received valproate, levetiracetam, topiramate, oxcarbazepine, clonazepam and lacosamide sequentially at different times, but he still had frequent seizures even after vagus nerve stimulation (VNS) implantation. He was diagnosed with idiopathic multidrug-resistant epilepsy.
Results
- c) Perampanel
- c) Perampanel
Perampanel is a third-generation antiepileptic drug, is a selective and non-competitive α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor antagonist, and has been approved for the treatment of adults and adolescents with focal epilepsy. Perampanel is effective as add-on therapy for young children with multidrug-resistant epilepsy who have previously undergone VNS implantation. Patient showed significant response to perampanel as add-on in a dose-dependent manner. Considering its favourable cognitive profile and the similar efficacy and safety profile of PER in children aged < 12 years as in older people, the use of perampanel as add-on could further reduce the seizure frequency for young children with drug-resistant epilepsy and even after VNS implantation, which may be attributed to its novel antiepileptic mechanism.
