Effectiveness and Tolerability of Perampanel in Children and Adolescents with Refractory Epilepsies: First Experiences

Objective  This article aims to report the first clinical experiences concerning effectiveness and tolerability of perampanel (PER) in a pediatric population with refractory epilepsies. Patients and Methods  This nonsponsored, observational, retrospective survey was conducted through collaboration with multiple centers in Europe. The clinical course of the first pediatric patients treated in these centers with PER was documented with the help of a questionnaire completed by the treating physicians. Effectiveness and adverse effects were evaluated. The study population consisted of 58 patients (mean age, 10.5 years; range, 2–17 years), suffering from various refractory epilepsies, classified as focal epilepsy ( n  = 36), unclassified generalized epilepsy ( n  = 12), Lennox–Gastaut syndrome ( n  = 5), West syndrome ( n  = 3), and Dravet syndrome ( n  = 2). Results  The response rate (≥ 50% seizure reduction) after the first 3 months of therapy was 31% (18/58 patients) in total. Complete seizure control was achieved in five patients (9% overall). Aggravation of seizures occurred in five cases (9%). The most frequently occurring adverse effects were reduced vigilance or fatigue ( n  = 16) and behavioral changes ( n  = 14). Discussion  PER seems to be effective also in children and adolescents with pharmaco-refractory epilepsies. Tolerability was acceptable.