Perampanel in brain tumor and SMART-syndrome related epilepsy - A single institutional experience.

Autor: Heugenhauser J; Department of Neurology, Medical University of Innsbruck, Austria., Iglseder S; Department of Neurology, Medical University of Innsbruck, Austria., Muigg A; Department of Neurology, Medical University of Innsbruck, Austria., Kerschbaumer J; Department of Neurosurgery, Medical University of Innsbruck, Austria., Stockhammer G; Department of Neurology, Medical University of Innsbruck, Austria., Nowosielski M; Department of Neurology, Medical University of Innsbruck, Austria. Electronic address: Martha.Nowosielski@i-med.ac.at., Unterberger I; Department of Neurology, Medical University of Innsbruck, Austria.
Jazyk: angličtina
Zdroj: Journal of the neurological sciences [J Neurol Sci] 2021 Apr 15; Vol. 423, pp. 117386. Date of Electronic Publication: 2021 Mar 05.
DOI: 10.1016/j.jns.2021.117386
Abstrakt: Epilepsy is common in patients with brain tumors and frequently presents as the first clinical manifestation of an underlying tumor. Despite a number of available antiepileptic drugs (AED), brain tumor related epilepsy (BTRE) may still be difficult to control. Recently, the AMPA (alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid)-type glutamate receptor antagonist perampanel (PER) is increasingly acknowledged as an attractive novel add-on AED for seizure control in BTRE. We present a single institutional experience reporting five individual cases with refractory BTRE treated with PER. In two of these five brain tumor patients, worsening of seizure control was caused by SMART-syndrome (stroke-like migraine attacks after radiation therapy). Efficacy of PER was assessed by the responder rate and by evaluating overall changes in seizure frequency before and during PER treatment. In our case series, a reduction in seizure frequency was observed in four out of five patients and the responder rate was 40%. In addition, both cases with symptomatic epilepsy associated with SMART-syndrome were successfully treated with PER. This case series supports the growing evidence that PER may become a promising add-on AED for the treatment of refractory BTRE as well as for seizure control in SMART-syndrome.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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