Epilepsy and paroxysmal conditions

Advanced search


Full Text:


Objective: to generalize the Russian experience with perampanel (PER) in routine clinical practice; to do this, the results of its use as an adjuvant partial epilepsy medication were retrospectively assessed. The study is still in progress now; therefore, the paper gives its preliminary results.

Materials and methods. The investigation included 52 patients with drug-resistant partial epilepsy. Their mean age was 28.92±14.02 years (a small number of the patients had not attained the age of 12 years); the proportion of men was 56%; the disease duration was over 10 years (69.2%); symptomatic epilepsy was in 76.9% with an epileptic focus being in the frontal (46.2%) and temporal (44.2%) regions. PER was prescribed to the majority (71.2%) of patients after three previous therapy lines. The baseline monthly rates of all types of seizures were 127.29±82.29; those of generalized seizures were 6.72±1.90.

Results. After addition of PER to therapy just within the first month, there was a significant reduction in the frequency of all types of seizures to 52.06±29.26 per month (Sign test; p=0.00001) and in that of secondary generalized seizures to 3.71±1.71 (Sign test; p=0.00001). The duration of PER administration was more than 6 months in the overwhelming majority of cases. In 58% of the patients, the frequency of seizures decreased by more than 50% (respondents). The lack of all types of seizures was noted in 8%; that of only secondary generalized seizures was in 31%. Adverse events were observed in 30.1% of the patients (aggression in 11.5% and somnolence in 9.6%; others were seen more rarely). The dose of PER was decreased because of side effects in 7 (13.5%) patients; the drug was discontinued in 4 (7.7%). The mean dose of PER for adults was as high as 6 mg.

About the Author

P. N. Vlasov
FSBEI HE A. I. Yevdokimov MSMSU MOH Russia
Russian Federation

MD, Professor of Neurology of General Medical Faculty,

Delegatskaya str., b. 20-1, Moscow, 127473


1. Avakyan G.N. Domestic Epileptology: problems and possible ways of development. Epileptology in neurosciences system. Collection of materials [Otechestvennaya epileptologiya: problemy i vozmozhnye puti razvitiya. Epileptologiya v sisteme neironauk. Sbornik materialov (in Russian)]. SPb. 2015. 4-5.

2. Belousova E.D. Epilepsiya i paroksizmal’nye sostoyaniya / Epilepsy and paroxysmal conditions. 2014; 1: 27-33.

3. Vlasov P.N. Nevrologiya neiropsikhiatriya psikhosomatika. 2016; 1: 4-10.

4. Gusev E. I., Gekht A.B., Khauzer V.A., Mil’chakova L.E., Churilin Yu.Yu. Epidemiology of epilepsy in Russia. Proc. Modern Epileptology. Ed. EI Gusev, AB Hecht [Epidemiologiya epilepsii v Rossii. V kn. Sovremennaya epileptologiya. Pod red. E. I. Guseva, A.B. Gekht (in Russian)]. Moscow. 2011; 77-84.

5. Zenkov L.R. Non-paroxysmal epileptic disorders [Neparoksizmal’nye epilepticheskie rasstroistva (in Russian)]. Moscow. 2016; 277 s.

6. Karlov V.A. Epilepsy in children and adults, women and men [Epilepsiya u detei i vzroslykh, zhenshchin i muzhchin (in Russian)]. Moscow. 2010; 720 s.

7. Karlov V.A., Belyaev O.V., Vlasov P.N., Zhidkova I.A., Volkov I.V. et al. Nevrologiya neiropsikhiatriya psikhosomatika. 2016; 1: 11-17.

8. Kissin M. Ya. Clinical Epileptology [Klinicheskaya epileptologiya (in Russian)]. Moscow. 2009; 252 s.

9. Lebedeva A.V., Kaimovskii I. L., Pavlov N.A., Gudkova A.A. Organization of medical care for patients with epilepsy in Moscow and treatment options. Proc. Diseases of the brain – the medical and social aspects. Ed. EI Gusev, AB Hecht [Organizatsiya meditsinskoi pomoshchi bol’nym epilepsiei v g. Moskve i vozmozhnosti terapii. V kn. Bolezni mozga – meditsinskie i sotsial’nye aspekty. Pod red. E. I. Guseva, A.B. Gekht (in Russian)]. 2016; 481-489.

10. Mkrtchyan V.R., Sergeev A.M., Pochigaeva K. I., Shpak I.A. Budget Impact Analysis Of Perampanel for Adjunctive Treatment in Epilepsy Patients 12 Years of Age and Older for Partial Onset Seizures with or without Secondary Generalization and Primary Generalized Tonic-Clonic Seizures in the Russian Federation. PHARMACOECONOMICS. Modern pharmacoeconomics and pharmacoepidemiology. 2016; 9 (2): 28-37 (In Russ.). DOI: 10.17749/2070-4909.2016.9.2.028-037.

11. Mukhin K. Yu., Mironov M.B., Petrukhin A.S. Epileptic syndromes. Diagnosis and therapy. Guidelines for doctors. 3rd ed. [Epilepticheskie sindromy. Diagnostika i terapiya. Rukovodstvo dlya vrachei. 3-e izd. (in Russian)]. Moscow. 2014; 375 s.

12. Berg A. T. Defining intractable epilepsy. Adv. Neurol. 2006; 97: 5-10.

13. Fisher R.S., Acevedo C., Arzimanoglou A., Bogacz A., Cross J.H., Elger C. E., Engel J. Jr., Forsgren L., French J.A., Glynn M., Hesdorffer D.C., Lee B. I., Mathern G.W., Moshé S. L., Perucca E., Scheffer I. E., Tomson T., Watanabe M., Wiebe S. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014, 55 (4): 475-82.

14. French J.A., Krauss G. L., Wechsler R. T., et al. Perampanel for tonic-clonic seizures in idiopathic generalized epilepsy. A randomized trial. Neurology. 2015; 85: 1-8.

15. Glauser T., Ben-Menachem E., Bourgeois B., et al. Updated ILAE evidence review of antiepileptic drug efficacy and effectiveness as initial monotherapy for epileptic seizures and syndromes. Epilepsia. 2013; 54 (3): 551-563.

16. Hanada T., Hashizume Y., Tokuhara N., Takenaka O., Kohmura N. et al. Perampanel: a novel, orally active, noncompetitive AMPAreceptor antagonist that reduces seizure activity in rodent models of epilepsy. Epilepsia. 2011; 52: 1331-1340.

17. Krauss G. L., Perucca E., Ben-Menachem E. et al. Long-term safety of perampanel and seizure outcomes in refractory partial-onset seizures and secondarily generalized seizures: Results from phase III extension study 307. Epilepsia. 2014; 55: 1058-1068.

18. Meador K. J., Yang H., Piña-Garza J.E., et al. Cognitive effects of adjunctive perampanel for partial-onset seizures: A randomized trial. Epilepsia. 2016; 57 (2): 243-251.

19. Mula M., Kanner A.M., Schmitz B., Schachter S. Antiepileptic drugs and suicidality: An expert consensus statement from the Task Force on Therapeutic Strategies of the ILAE Commission on Neuropsychobiology. Epilepsia. 2013; 54 (1): 199-203.

20. Panayiotopolos C.P. A clinical guide to epileptic syndromes and their treatment. Revised second edition. Springer. 2010; 654 p.

21. Renroe B., Yang H., Williams B. Interim efficacy and safety analysis of adjunctive perampanel in the adolescent population from the extension phase of 3 double-blind, placebo-controlled phase 3 (core) studies in patients with refractory partial-onset seizures. 42nd Annual Meeting of the Child Neurology Society; 30 Oct 2 Nov 2013; Austin., TX, USA, 2013.

22. Rogawski M.A. Revisiting AMPA receptors as an antiepileptic drug target. Epilepsy Currents. 2011; 11: 56-63.

23. Steinhoff B. J., Hamer H., Trinka E. et al. A multicenter survey of clinical experiences with perampanel in real life in Germany and Austria. Epilepsy Res. 2014; 108: 986-988.

24. The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care. Issued: January 2012 last modified: December 2013. NICE clinical guideline 137.


For citations:

Vlasov P.N. NEW OPPORTUNITIES PHARMACOTHERAPY PATIENTS WITH REFRACTORY EPILEPSY. Epilepsy and paroxysmal conditions. 2016;8(4):49-57. (In Russ.)

Views: 672

ISSN 2077-8333 (Print)
ISSN 2311-4088 (Online)