Abstracts

Rationale: To evaluate the efficacy and tolerability of Perampanel in our patients, children and adults with different epileptic encephalopathies emphasizing in aggressive behavior and irritability, due to the high prevalence of these disorders in these patients. Methods: We are analyzing the patients with epileptic encephalopathies treated during 2019, presenting here those that we have started Perampanel. We rewieved type of encephalopathies, concomitant antiepileptic drugs -AEDs-, dose of perampanel, frequency of seizures and secondary effects, emphasizing behavioral disturbance. Results: So far we have included 18 patients: 12 males and 6 females, the mean age was 14.2 years (range 6–58 years), 6 patients aged <12 years. 55% reported connatal encephalopathy (6 hypoxia-ischemia, 2 hydrocephalus, 2 infections, and one tuberous sclerosis), Two patients suffered Lennox-Gastaut syndrome, one, Down, and another one Rett syndrome. Two cases presented cortical dysplasia and polymicrogyria. Mean number of concomitant AEDs was 3,38 with levetiracetam used in 44 % of patients. Mean PER daily dose was 7 mg(4–10 mg). After 3 months of follow-up the retention rate is 83 % (3/18). 9 patients reported > 50% seizure frequency reduction, and 16,6 % is over 75%. 6 patients -33.3% - also refer improvement of the sleep pattern.in relation to adverse effects, irritability and aggressiveness were found in 7 patients -38,8%-, of whom 4 were taking levetiracetam concomitantly. In 3 cases -16,6%- , perampanel had to be suspended, the rest improved by decreasing the dose or suspending levetiracetam. Other adverse effects were drowsiness, gastrointestinal upset and tachycardia Conclusions: Perampanel is effective in improving the frequency of seizures, as well as the sleep pattern, in our patients with epileptic encephalopathies. Irritability and behavioral disorders are frequent, especially in patients taking levetiracetam concomitantly, which is important to take into account when reducing or adjusting the doses of both. We will continue to include patients in order to improve our knowledge. Funding: No funding