Efficacy of Immediate Perampanel Oral Loading in Convulsive Status Epilepticus: A Single-Center Experience of Consecutive 22 Patients

Convulsive Status epilepticus (CSE) is a relatively common neurological emergency with high morbidity and mortality and should be stopped as soon as possible to avoid cerebral damage. Despite novel anti-epileptic drugs, its control rate has not been changed sufficiently. Perampanel (PER) is an antagonist of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor which is identified as a potential therapeutic target for the treatment of SE. Data on the efficacy of PER in treatment of SE in humans are still insufficient due to lack of homogenous study with high doses and very early administration of the drug. We retrospectively analyzed treatment response, the outcome of all patients with CSE in our hospital who received 8mg of PER oral loading from January 2018 to June 2019. Twenty-two consecutive patients with CSE were included. The etiology and the seizure types were wide-ranging. Fifteen out of 22 patients suffering from CSE responded to PER oral loading (68%) and they became seizure-free within 24 hours. The responders’ outcome after 30 days was significantly better than that of non-responders. There were no severe side effects but minor somnolence which was acceptable for emergent cases. This should be applied to the standard treatment protocol of CSE.