Effectiveness and tolerability of perampanel in сhildren and adolescents (own experience of Svt. Luka’s Institute of Child Neurology and Epilepsy)

Despite the significant advances in epileptology, including various new effective treatments for drug-resistant epilepsy in children, there is still a relatively large proportion of patients ineligible for surgery and alternative treatments (such as vagus nerve stimulation and ketogenic diet). Drug-resistant epilepsy accounts for approximately 30 % of all forms of epilepsy and is particularly common among patients with focal seizures. The search for new antiepileptic drugs (AEDs) is critical for these patients.Perampanel (Fycompa®, Eisai) is a novel AED that employs a fundamentally different mechanism of action compared to existing AEDs. Perampanel is a powerful highly selective non-competitive postsynaptic AMPA receptor antagonist acting at the level of neocortex and in the hippocampus. Phase III clinical trials demonstrated its high efficacy and good tolerability in patients with drug-resistant focal seizures. Randomized placebo-controlled trials assessing the efficacy of perampanel as add-on therapy showed that perampanel at a dose of 4–12 mg/day significantly reduced the frequency of focal seizures in patients with drug-resistant epilepsy along with a good safety and tolerabili