000 02847cam a2200313 4500500
005 20250121162743.0
041 _afre
042 _adc
100 1 0 _aQu, Rui
_eauthor
700 1 0 _a Dai, Yuanyuan
_eauthor
700 1 0 _a Qu, Xiangju
_eauthor
700 1 0 _a Li, Yan
_eauthor
700 1 0 _a Shao, Xuejun
_eauthor
700 1 0 _a Zhou, Rui
_eauthor
700 1 0 _a Zhu, Yali
_eauthor
700 1 0 _a Chen, Xuqin
_eauthor
245 0 0 _aUse of perampanel in children with refractory epilepsy of genetic aetiology
260 _c2022.
500 _a87
520 _aObjectivePathogenic mutations in refractory childhood epilepsy are being increasingly discovered. In this study, we analysed the efficacy and tolerability of perampanel as treatment for genetically-related refractory childhood epilepsy. MethodsThis prospective study, conducted in China, included 50 patients with refractory epilepsy of genetic aetiology, who were treated with adjunctive perampanel therapy. Perampanel treatment was considered effective when the seizure frequency was reduced by >50%. Perampanel treatment was evaluated over at least nine months, from January 2020. ResultsA total of 184 paediatric patients with refractory epilepsy received addon perampanel therapy, and of these, 128 received treatment for nine months and underwent genetic analysis. Fifty children were identified with pathogenic or likely pathogenic variants. A total of 24 different causative monogenic mutations were found, and the most common causative monogenic variants were observed in the SCN1A gene ( n = 15). The mean maximal dose of perampanel was 3.4±1.2 mg/day in responders. The response rates to perampanel in children with genetically-related refractory epilepsy ( n=50) were 68.0%, 58.0%, and 46.0% at three, six and nine months post-initiation, respectively. Adverse events were reported in 23 patients (46.0%) with genetic aetiology. Somnolence, ataxia, and irritability were the most common adverse events. The response rates to perampanel in children with pathogenic or likely pathogenic variants associated with Dravet syndrome, tuberous sclerosis, mitochondrial encephalopathy with lactic acidosis and stroke-like episodes, Rett syndrome, and dentatorubral-pallidoluysian atrophy were high. SignificanceA low maintenance dose of perampanel may be effective and welltolerated as adjunctive treatment in children with refractory epilepsy of genetic aetiology.
690 _arefractory epilepsy
690 _atuberous sclerosis
690 _agenetic aetiology
690 _amitochondrial encephalopathy
690 _aperampanel
690 _aDravet syndrome
786 0 _nEpileptic Disorders | Vol 24 | 4 | 2022-04-01 | p. 687-695 | 1294-9361
856 4 1 _uhttps://shs.cairn.info/revue-epileptic-disorders-2022-4-page-687?lang=en&redirect-ssocas=7080
999 _c612194
_d612194