Introduction: Perampanel is a new non-competitive anticonvulsant recently introduced to the local Asian paediatric population. Limited data on this specific group of patients are available to date. The series of patients treated since its first introduction at a regional hospital was reviewed. The objective of the study to focus on efficacy and tolerability, guiding future drug usage.

Methods: retrospective cohort in a regional hospital since the medication first introduced June 2015 to the local setting. The focus is to evaluate the efficacy and tolerability, at 6-months and 12-months, comparing to published adult studies.

Results: Of the 11 patients identified, two patients were excluded as they did not reach minimal follow-up at 6 months. All patients reaching the 6-month follow-up continued perampanel at the 12-month follow-up. The mean age of starting perampanel was 15.3 years (12.6-17.3) and the mean time lapsed between diagnosis and starting perampanel was 8 years (2-15 years). Suboptimal responses to 2 anticonvulsants were noted before perampanel introduction (mean 1.9, range 1-4), and the patients were taking one concomitant anticonvulsants on average (mean 0.7, range 1-3). The response rate was 66.7% by 6 months and 88.9% by 12 months, defined by at least 50% reduction in clinical seizure. Only one patient remained seizure-free however. Irritability was observed in 6 patients (67%).

Conclusion/Discussion: Perampanel if efficacious and well tolerated in paediatric patients. Irritability was the commonest side-effect. Results are comparable to adult studies.