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Experience of Low Dose Perampanel to Add-on in Glioma Patients with Levetiracetam-uncontrollable Epilepsy

After introduction of levetiracetam (LEV), treatment of seizures in patients with malignant brain tumors has prominently improved. On the other hand, we still experience some cases with LEV-uncontrollable epilepsy. Perampanel (PER) is a noncompetitive α-amino-3-hydroxy-5-methyl-4-isoaxazolepropionat...

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Autores principales: CHONAN, Masashi, SAITO, Ryuta, KANAMORI, Masayuki, OSAWA, Shin-ichiro, WATANABE, Mika, SUZUKI, Hiroyoshi, NAKASATO, Nobukazu, TOMINAGA, Teiji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970066/
https://www.ncbi.nlm.nih.gov/pubmed/31748440
http://dx.doi.org/10.2176/nmc.oa.2018-0245
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author CHONAN, Masashi
SAITO, Ryuta
KANAMORI, Masayuki
OSAWA, Shin-ichiro
WATANABE, Mika
SUZUKI, Hiroyoshi
NAKASATO, Nobukazu
TOMINAGA, Teiji
author_facet CHONAN, Masashi
SAITO, Ryuta
KANAMORI, Masayuki
OSAWA, Shin-ichiro
WATANABE, Mika
SUZUKI, Hiroyoshi
NAKASATO, Nobukazu
TOMINAGA, Teiji
author_sort CHONAN, Masashi
collection PubMed
description After introduction of levetiracetam (LEV), treatment of seizures in patients with malignant brain tumors has prominently improved. On the other hand, we still experience some cases with LEV-uncontrollable epilepsy. Perampanel (PER) is a noncompetitive α-amino-3-hydroxy-5-methyl-4-isoaxazolepropionate acid receptor antagonist that has recently been approved for treating focal epilepsy as a secondary drug of choice. Available literature reporting PER medication in patients with gliomas is still sparse. Here, we report our initial experience with glioma patients and report efficacy of adding low dose 2–4 mg PER to LEV in patients whose seizure were uncontrollable with LEV monotherapy. Clinical outcome data of 18 consecutive patients were reviewed. This included nine males and nine females aged 24–76 years (median, 48.5 years), treated for glioma between June 2009 to December 2018. We added PER to patients with LEV-uncontrollable epilepsy. Adverse effects, irritability occurred in two patients, but continuous administration was possible in all cases. Though epileptic seizures occurred in four cases receiving 2 mg PER, 17 cases achieved seizure freedom by dose increments; final dose, 2–4 mg PER added to LEV 500–3000 mg. Our study revealed anti-epileptic efficacy of low dose PER 2–4 mg as first add-on therapy to LEV in glioma patients who have failed or intolerable to LEV monotherapy. Low dose PER added on to LEV may have favorable efficacy with tolerable adverse effects in glioma patients with LEV-uncontrollable epilepsy.
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spelling pubmed-69700662020-01-22 Experience of Low Dose Perampanel to Add-on in Glioma Patients with Levetiracetam-uncontrollable Epilepsy CHONAN, Masashi SAITO, Ryuta KANAMORI, Masayuki OSAWA, Shin-ichiro WATANABE, Mika SUZUKI, Hiroyoshi NAKASATO, Nobukazu TOMINAGA, Teiji Neurol Med Chir (Tokyo) Original Article After introduction of levetiracetam (LEV), treatment of seizures in patients with malignant brain tumors has prominently improved. On the other hand, we still experience some cases with LEV-uncontrollable epilepsy. Perampanel (PER) is a noncompetitive α-amino-3-hydroxy-5-methyl-4-isoaxazolepropionate acid receptor antagonist that has recently been approved for treating focal epilepsy as a secondary drug of choice. Available literature reporting PER medication in patients with gliomas is still sparse. Here, we report our initial experience with glioma patients and report efficacy of adding low dose 2–4 mg PER to LEV in patients whose seizure were uncontrollable with LEV monotherapy. Clinical outcome data of 18 consecutive patients were reviewed. This included nine males and nine females aged 24–76 years (median, 48.5 years), treated for glioma between June 2009 to December 2018. We added PER to patients with LEV-uncontrollable epilepsy. Adverse effects, irritability occurred in two patients, but continuous administration was possible in all cases. Though epileptic seizures occurred in four cases receiving 2 mg PER, 17 cases achieved seizure freedom by dose increments; final dose, 2–4 mg PER added to LEV 500–3000 mg. Our study revealed anti-epileptic efficacy of low dose PER 2–4 mg as first add-on therapy to LEV in glioma patients who have failed or intolerable to LEV monotherapy. Low dose PER added on to LEV may have favorable efficacy with tolerable adverse effects in glioma patients with LEV-uncontrollable epilepsy. The Japan Neurosurgical Society 2020-01 2019-11-21 /pmc/articles/PMC6970066/ /pubmed/31748440 http://dx.doi.org/10.2176/nmc.oa.2018-0245 Text en © 2020 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Original Article
CHONAN, Masashi
SAITO, Ryuta
KANAMORI, Masayuki
OSAWA, Shin-ichiro
WATANABE, Mika
SUZUKI, Hiroyoshi
NAKASATO, Nobukazu
TOMINAGA, Teiji
Experience of Low Dose Perampanel to Add-on in Glioma Patients with Levetiracetam-uncontrollable Epilepsy
title Experience of Low Dose Perampanel to Add-on in Glioma Patients with Levetiracetam-uncontrollable Epilepsy
title_full Experience of Low Dose Perampanel to Add-on in Glioma Patients with Levetiracetam-uncontrollable Epilepsy
title_fullStr Experience of Low Dose Perampanel to Add-on in Glioma Patients with Levetiracetam-uncontrollable Epilepsy
title_full_unstemmed Experience of Low Dose Perampanel to Add-on in Glioma Patients with Levetiracetam-uncontrollable Epilepsy
title_short Experience of Low Dose Perampanel to Add-on in Glioma Patients with Levetiracetam-uncontrollable Epilepsy
title_sort experience of low dose perampanel to add-on in glioma patients with levetiracetam-uncontrollable epilepsy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970066/
https://www.ncbi.nlm.nih.gov/pubmed/31748440
http://dx.doi.org/10.2176/nmc.oa.2018-0245
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