Nakano Naoki, Fujimoto Kouichiro, Miyauchi Masaharu, Takahashi Jun C
Department of Neurosurgery, Kindai University School of Medicine Address, 377-2, Ohno-Higashi, Osaka-Sayama, 589-8511, Osaka, Japan.
Acta Neurol Belg. 2025 Aug 18. doi: 10.1007/s13760-025-02865-1.
The aim of this study was to examine the efficacy of Perampanel (PER) monotherapy for patients with seizures in a single-centre in Japan. The National Health Insurance began covering PER monotherapy in Japan since January 2020, after which we began using PER as monotherapy for patients with epilepsy at our institute.
All patients given PER between January 2020 and December 2022 were evaluated in this retrospective study. Treatment outcomes (including the seizure rate and seizure- free status) and patient sex, seizure type, and seizure aetiology were evaluated.
Sixty-three patients (29 females, 34 males) receiving PER monotherapy as the first-line antiseizure medication for epilepsy were evaluated. The age range was 12 to 88 years, with a mean age of 64.5 ± 18.8years. The follow-up period ranged from 194 days to 1004days, with a median of 576 days from PER initiation. A total of 49 patients (77.8%) were seizure free, while the other 14 patients had incomplete seizure control, including 2 patients (3.2%) who had a 75-99% reduction in seizures, 4 patients (6.3%) who had a 50-74% reduction in seizures,8 patients (12.7%) who had a 25-49% reduction in seizures, and no patients with a 0-24% reduction in seizures. The median PER dose was 2 mg (range; 2-8 mg). No patients discontinued PER monotherapy owing to adverse effects such as transient dizziness at initial administration.
Perampanel monotherapy was effective for treating a wide spectrum of seizures, especially seizures related to lesions such as brain tumours, stroke and trauma. Seizure control could be achieved with a minimum dose of PER (2 mg/day).
本研究旨在探讨吡仑帕奈（PER）单药治疗对日本某单中心癫痫患者的疗效。自2020年1月起，日本国民健康保险开始覆盖PER单药治疗，此后我们开始在本机构将PER用于癫痫患者的单药治疗。
对2020年1月至2022年12月期间所有接受PER治疗的患者进行了这项回顾性研究。评估了治疗结果（包括癫痫发作率和无癫痫发作状态）以及患者的性别、癫痫发作类型和癫痫病因。
对63例接受PER单药治疗作为癫痫一线抗癫痫药物的患者进行了评估。年龄范围为12至88岁，平均年龄为64.5±18.8岁。随访期为194天至1004天，从开始使用PER起的中位时间为576天。共有49例患者（77.8%）无癫痫发作，而其他14例患者癫痫控制不完全，其中2例患者（3.2%）癫痫发作减少75 - 99%，4例患者（6.3%）癫痫发作减少50 - 74%，8例患者（12.7%）癫痫发作减少25 - 49%，无癫痫发作减少0 - 24%的患者。PER的中位剂量为2mg（范围：2 - 8mg）。没有患者因初始给药时短暂头晕等不良反应而停用PER单药治疗。
吡仑帕奈单药治疗对多种癫痫发作有效，尤其是与脑肿瘤、中风和创伤等病变相关的癫痫发作。使用最低剂量的PER（2mg/天）即可实现癫痫控制。
