Zastosowanie perampanelu w leczeniu napadów i epilepsji związanych z autoimmunologicznym zapaleniem mózgu u dzieci: seria przypadków retrospektywna
Perampanel use in pediatric autoimmune encephalitis-related seizures and epilepsy: a retrospective case series
W skrócie
Badanie dotyczyło 14 dzieci z autoimmunologicznym zapaleniem mózgu, które otrzymywały lek zwany perampanel. Wyniki pokazały, że u ponad połowy dzieci zmniejszyła się częstość napadów padaczkowych, a u niektórych napady całkowicie ustały, bez poważnych działań niepożądanych. Lekarze uważają, że perampanel może być pomocny w leczeniu padaczki związanej z zapaleniem mózgu u dzieci, choć potrzebne są dalsze badania.
Oryginalny abstract (angielski)
OBJECTIVE: There is limited data regarding the use of antiseizure medications (ASMs) for autoimmune encephalitis (AE)-related seizures and epilepsy, particularly in pediatric patients. Perampanel (PER) was associated with seizure improvement in controlling seizures of inflammatory etiology. The objective of this study was to describe seizure outcomes and tolerability after PER administration in pediatric patients with AE-related seizures and epilepsy. METHODS: This retrospective, single-center study (2020-2025) reviewed 14 pediatric patients diagnosed with AE who received PER during either the acute symptomatic phase or the chronic phase of autoimmune-associated epilepsy. Clinical data, seizure outcomes, concomitant treatments, and adverse events were retrospectively collected and descriptively analyzed. RESULTS: Fourteen pediatric patients with AE (9 male, 5 female; median age 8.5 years) were treated with PER. The median maintenance dose of PER ranged from 2 to 4 mg per day. According to the classification by the International League Against Epilepsy (ILAE), the patients were divided into two groups: (a) acute symptomatic seizures secondary to AE (ASSAE), and (b) autoimmune-associated epilepsy (AAE). In the ASSAE group, 42.8% (3/7) of the patients achieved seizure resolution during the acute phase. In the AAE group, at the 3-month endpoint, 57.1% (4/7) of patients achieved a ≥ 50% reduction in seizure frequency compared to baseline, meeting the responder criteria. Additionally, 42.8% (3/7) of patients in the AAE group achieved seizure freedom at the 3-month endpoint. No serious adverse events were reported in either group. CONCLUSION: In this small retrospective case series, seizure improvement was observed in some pediatric patients with AE-related seizures or epilepsy after PER administration, without serious adverse events. Because most patients received concomitant ASMs and immunotherapy, these findings should be interpreted as preliminary and hypothesis-generating. CLINICAL TRIAL REGISTRATION: https://www.chictr.org.cn/showproj.html?proj=191349, identifier: ChiCTR2300074696.