Perampanel is a novel
antiepileptic drug, which antagonises
AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid)
glutamate receptor. We describe
perampanel as an adjunctive treatment for FIRES (febrile
infection-related
epilepsy syndrome) and other
drug-resistant epilepsies. A single-centre, observational, retrospective study involving 20 pediatric patients was conducted.
Perampanel was started for three patients with FIRES, achieving seizure cessation in two patients within a day and on days 19 and 32 of illness. Doses used ranged from 4 to 12 mg/day, without any adverse effects reported or discontinuation of
therapy. Responder-rate for other
drug-resistant epilepsies is 25%. Median time to achieve ≥50% seizure reduction was 80 days (range: 26-326 days). Adverse effect reported in 47% of the patients includes central nervous system-related, and
thrombocytopenia. Eight patients discontinued
perampanel, because of ineffectiveness or adverse effects. The median time on
perampanel before discontinuation was 179 days (range: 94-345 days).
Perampanel may be of benefit in pediatrics FIRES and is of utility in other
drug-resistant epilepsies.