Epilepsy Unit, Department of Neurology, Hospital General Universitario de Valencia, Tres Cruces Av, 2, 46014, Valencia, Spain; Epilepsy Unit, Department of Clinical Neurophysiology, Lluis Alcanyis Hospital, Carretera Xátiva-Silla, Km 2, 46800, Xàtiva, Valencia, Spain.
Epilepsy Unit, Department of Clinical Neurophysiology, Lluis Alcanyis Hospital, Carretera Xátiva-Silla, Km 2, 46800, Xàtiva, Valencia, Spain.
Epilepsy Res. 2020 Sep;165:106378. doi: 10.1016/j.eplepsyres.2020.106378. Epub 2020 May 31.
Quantifying epileptiform discharges before and after the initiation of treatment can be useful for evaluating the efficacy of antiepileptic drugs in generalized epilepsy. The aim of this study was to determine if the selective α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor antagonist perampanel alters the electroencephalographic signals in patients with drug resistant generalized seizures (primary or secondary). We also assessed the clinical efficacy, safety and tolerability of perampanel as an adjunctive treatment for patients with refractory generalized seizures after 3, 6 and 12 months of treatment to determine if there is an electro-clinical correlation. We carried out a 1-year retrospective, unicentric, observational, descriptive and non-interventional study to analyze changes in epileptiform discharges, seizure frequency and adverse effects in patients with generalized seizures taking perampanel as an add-on treatment. Perampanel significantly reduced the total number, total duration, maximal duration and average duration of epileptiform discharges in patients with primary generalized epilepsy (n = 44). In patients with focal onset epilepsy and secondary generalized seizures (n = 8) significant decreases in the maximal duration and average duration of epileptiform discharges were found. These findings correlate with the significant decrease in seizure frequency and clinical improvement observed after taking perampanel as an adjunctive therapy for 3, 6 and 12 months. To our knowledge, this is the first study to show that perampanel reduces epileptiform activity, and that this effect correlates with patients' clinical improvement. Analysing patients' electroencephalographic activity in response to perampanel could be useful for assessing the drug's efficacy and optimising adjunctive treatments.
定量分析治疗前后的癫痫样放电可用于评估抗癫痫药物在全面性癫痫中的疗效。本研究旨在确定选择性α-氨基-3-羟基-5-甲基-4-异恶唑丙酸（AMPA）受体拮抗剂吡仑帕奈是否会改变耐药性全面性发作（原发性或继发性）患者的脑电图信号。我们还评估了吡仑帕奈作为附加治疗药物对难治性全面性发作患者的临床疗效、安全性和耐受性，以确定是否存在电临床相关性。我们进行了为期 1 年的回顾性、单中心、观察性、描述性和非干预性研究，以分析接受吡仑帕奈附加治疗的全面性发作患者癫痫样放电、发作频率和不良反应的变化。吡仑帕奈可显著减少原发性全面性癫痫患者（n = 44）的总放电次数、总持续时间、最大持续时间和平均持续时间。在局灶性起始性癫痫和继发性全面性发作患者（n = 8）中，发现癫痫样放电的最大持续时间和平均持续时间显著减少。这些发现与服用吡仑帕奈作为附加治疗后 3、6 和 12 个月观察到的发作频率显著减少和临床改善相关。据我们所知，这是第一项表明吡仑帕奈可减少癫痫样活动且这种效果与患者临床改善相关的研究。分析患者对吡仑帕奈的脑电图反应可能有助于评估药物疗效并优化附加治疗。
