Introduction:

Perampanel, a selective, noncompetitive AMPA receptor antagonist, has been approved for the adjunctive treatment of primary generalized tonic-clonic seizures and partial-onset seizures. There are few studies reporting about the efficacy and tolerability of perampanel in children under 7 years old with refractory epilepsy. We aimed to describe our clinical experience in this group.

Methods:

This single-center retrospective observational study was performed via reviewing the medical records of children below 7 years old with epilepsy, treated with perampanel in our pediatric clinic from January 2016 to March 2018.

Results:

Total 39 patients (19 females, 20 males) using perampanel were enrolled in the present study, with the mean age of 2 years (range, 0–6 years). The types of epilepsy were classified as symptomatic (n=23) and cryptogenic (n=16). The number of concomitant antiepileptic drugs was 3.6 (range 1-5). The response rate (defined as 50% seizure reduction) after the first 6 months of therapy was 38.2%. Freedom of seizures was reached in 7 patients (20.5%). Total three patients got lost of follow-up. Adverse events were reported in 9 (23%), which included emotional change (n=4), lethargy (n=3), nasal bleeding (n=1), and drug allergy (n=1).

Conclusion:

The effectiveness and tolerability of perampanel in children under 7 years old with refractory epilepsy were good. Perampanel can be considered to be drug of choice in children under 7 years with refractory epilepsy.