Perampanel Treatment for Refractory Status Epilepticus in a Neurological Intensive Care Unit

Ho, Chen-Jui; Lin, Ching‐Yuan; Lu, Yanting; Shih, Frank Y.; Hsu, Che-Wei; Tsai, Wan‐Chen; Tsai, Meng-Han

doi:10.1007/s12028-019-00704-9

Cited by 23 publications

(22 citation statements)

References 24 publications

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“…Perampanel is used for the adjunctive treatment of epilepsy up to 12 mg/day and acts as an orally active noncompetitive α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist to reduce glutamate-mediated postsynaptic excitation [118][119][120].…”

Section: Perampanelmentioning

confidence: 99%

Super-Refractory Status Epilepticus: Prognosis and Recent Advances in Management

Kirmani¹,

Au²,

Ayari³

et al. 2021

Aging and disease

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Super-refractory status epilepticus (SRSE) is a life-threatening neurological emergency with high morbidity and mortality. It is defined as "status epilepticus (SE) that continues or recurs 24 hours or more after the onset of anesthesia, including those cases in which SE recurs on the reduction or withdrawal of anesthesia." This condition is resistant to normal protocols used in the treatment of status epilepticus and exposes patients to increased risks of neuronal death, neuronal injury, and disruption of neuronal networks if not treated in a timely manner. It is mainly seen in patients with severe acute onset brain injury or presentation of new-onset refractory status epilepticus (NORSE). The mortality, neurological deficits, and functional impairments are significant depending on the duration of status epilepticus and the resultant brain damage. Research is underway to find the cure for this devastating neurological condition. In this review, we will discuss the wide range of therapies used in the management of SRSE, provide suggestions regarding its treatment, and comment on future directions. The therapies evaluated include traditional and alternative anesthetic agents with antiepileptic agents. The other emerging therapies include hypothermia, steroids, immunosuppressive agents, electrical and magnetic stimulation therapies, emergent respective epilepsy surgery, the ketogenic diet, pyridoxine infusion, cerebrospinal fluid drainage, and magnesium infusion. To date, there is a lack of robust published data regarding the safety and effectiveness of various therapies, and there continues to be a need for large randomized multicenter trials comparing newer therapies to treat this refractory condition.

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Section: Perampanelmentioning

confidence: 99%

Super-Refractory Status Epilepticus: Prognosis and Recent Advances in Management

Kirmani¹,

Au²,

Ayari³

et al. 2021

Aging and disease

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show abstract

“…Perampanel works as a noncompetitive α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist, causing a reduction in postsynaptic glutamate. 18,61 Traditionally, it has been used as monotherapy for focal seizures or as an adjunct for GTC seizures. Although it has shown an effect on the termination of SE in animal studies, there have been limited studies evaluating its efficacy for acute symptomatic seizures and SE.…”

Section: Lacosamidementioning

confidence: 99%

“…Although it has shown an effect on the termination of SE in animal studies, there have been limited studies evaluating its efficacy for acute symptomatic seizures and SE. 61,62 Although data are sparse, there seems to be growing potential for diversifying its use. One limitation is that it currently only comes in an PO formulation.…”

Section: Lacosamidementioning

confidence: 99%

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Acute Provoked Seizures—Work-Up and Management in Adults

Moosavi

Swisher

2020

Semin Neurol

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Acute provoked seizures, also known as acute symptomatic seizures, occur secondary to a neurological or systemic precipitant, commonly presenting as a first-time seizure. In this article, we will discuss etiology, emergent protocols, medical work-up, initial treatment, and management of these seizures. The definitions, classifications, and management of convulsive status epilepticus and nonconvulsive status epilepticus in an acute setting will also be reviewed.

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“…Its treatment remains a relatively 'evidence-free zone, ' and is frequently difficult to abort, making any additional treatment options relevant and potentially important. In this issue of Neurocritical Care, Ho et al [1] reported a retrospective analysis of 67 consecutive patients with RSE, 22 of whom were treated with perampanel. Perampanel, a novel ASD, acts as a noncompetitive α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist, and has the effect of reducing glutamatemediated postsynaptic excitation.…”

mentioning

confidence: 99%

Perampanel for Refractory Status Epilepticus… Another Tool in the Armamentarium

Hocker

2019

Neurocrit Care

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Perampanel Treatment for Refractory Status Epilepticus in a Neurological Intensive Care Unit

Cited by 23 publications

References 24 publications

Super-Refractory Status Epilepticus: Prognosis and Recent Advances in Management

Super-Refractory Status Epilepticus: Prognosis and Recent Advances in Management

Acute Provoked Seizures—Work-Up and Management in Adults

Perampanel for Refractory Status Epilepticus… Another Tool in the Armamentarium

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