Abstracts

Rationale: Perampanel is an antiepileptic drug (AED) AMPA receptor antagonist developed for the treatment of epilepsy. The drug targets the glutamatergic postsynaptic receptors. The posology is once daily. The aim of this study is to evaluate the effect of Perampanel on seizure frequency in drug resistant patients with seizures predominantly during sleep and compare it with those who present both day and night-time seizures. Methods: Retrospective analysis of 50 patients with pharmacoresistant epilepsy treated with Perampanel followed from 2015 to 2018. Patients with seizures during the sleep or night-time seizures were defined as those who presented = 80% of seizures during sleep. Efficacy was evaluated in the last follow-up. Responders are defined as =50% seizure reduction from baseline seizure frequency. Results: We analyzed 50 patients with pharmacoresistant epilepsy (56% women) with a mean age of 36 years, mean time of epilepsy of 25 years, from which 84% had a focal epilepsy (30% frontal lobe, 35% temporal lobe, 15% parieto-occipital epilepsy and 6% of insular epilepsy). Six percent of our patients presented a generalized epilepsy and 10% a multifocal epilepsy.  Eight patients fulfilled the criteria previously mentioned for seizures during sleep. Median number of concomitant AEDs were 3.  Sodium channel blockers were administered in 86% of the sample.Median dose of Perampanel was 6 mg.  The median time of Perampanel use was 19 months. Twenty-nine percent of the patients treated with Perampanel were responsive (20% of them were from the group with sleep time seizures and 29% with daytime and night-time seizures).  Four patients were seizure-free after treatment with Perampanel, 3 of them from the group with seizures during sleep. Perampanel was ceased on 46% of the patients treated because of adverse events. The percentage of patients who continue with the treatment is 63% in the night-time group and 52% in the daytime group. The comparative of efficacy did not show statistical significance (p > 0,8). Conclusions: Perampanel is an effective drug to treat seizures during sleep. In our study, we found similar efficacy in the group with seizures during sleep and the group with daytime and night-time seizures. Funding: None