A Severe Dementia Case in End of Life Care with Psychiatric Symptoms Treated by Perampanel.

Abstract

Epilepsy is known to comorbid with Alzheimer's disease. It can promote cognitive decline, and eventually worsen their prognosis and mortality. It is sometimes difficult to find a suitable drug because of the adverse effects. Perampanel has a unique mechanism of action that antagonizes α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid type glutamate receptor. Here, we report a case of severe dementia due to Alzheimer's disease with intractable epilepsy, which perampanel effected for controlling seizures with less adverse effects. The subject is an 89-year-old Japanese woman with severe dementia due to Alzheimer's disease and intractable myoclonic epilepsy. She also had psychiatric symptoms, such as circadian rhythm disorder and irritability. Valproic acid, lacosamide, or carbamazepine were prescribed, but none of them was effective. Shortly after perampanel started, however, myoclonus and these psychiatric symptoms improved. Moreover, it did not cause any obvious adverse effects, which made it possible to continue perampanel until the end of her life. Perampanel may be useful for controlling intractable epilepsy accompanied by Alzheimer's disease. It may also improve psychiatric symptoms with less adverse effect. Accumulation of studies is necessary to evaluate the effectiveness of perampanel on the epilepsy of Alzheimer's disease patients and further understand that mechanism.

• Authors: Asaki Kumamoto, Yuhei Chiba, Akira Suda, Akitoyo Hishimoto, Akihiko Kase
• Journal: Journal of epilepsy research (J Epilepsy Res) Vol. 11 Issue 1 Pg. 93-95 (Jun 2021) ISSN: 2233-6249 [Print] Korea (South)
• PMID: 34395228 (Publication Type: Case Reports)
• Copyright: Copyright © 2021 Korean Epilepsy Society.