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Journal of Neuro-Oncology
Published in: Journal of Neuro-Oncology 3/2017

01-07-2017 | Clinical Study

Seizure response to perampanel in drug-resistant epilepsy with gliomas: early observations

Authors: Charles Vecht, Alberto Duran-Peña, Caroline Houillier, Thomas Durand, Laurent Capelle, Gilles Huberfeld

Published in: Journal of Neuro-Oncology | Issue 3/2017

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Abstract

Drug-resistant epilepsy (DRE) occurs commonly in gliomas, possibly due to a shared mechanism of AMPA-activation involving both seizure activity and tumor growth. We tested the AMPA-receptor blocker perampanel (PER) in patients with DRE in low- and high-grade gliomas. Seizure response was defined as 50% drop in seizure frequency or as seizure-freedom. Cognitive function was examined by computerized test on cognitive speed (CTCS), which is sensitive to the type of cognitive dysfunction associated with epilepsy and use of anticonvulsants. Treatment policy included reduction of dose or discontinuation of one or more concurrent AEDs, once a seizure-free response was observed. Twelve patients were included patients, median age 41 years, 9 men versus 3 women and 6 months median duration of follow-up. An objective seizure response (75%) was observed in 9 (75%) out of 12 patients: 50%-seizure response in 3, seizure-freedom in 6, which is plainly more than seen with other types of DRE. Side-effects occurred in six patients. Cognitive function as examined by CTCS improved in six out of eight associated withlowering of concurrent AEDs. The final median dose of PER was 8 mg (varying between 2 and 12 mg). These results of an objective seizure response in 9 (75%) out of 12 patients treated by PER in DRE may be interpreted as a surrogate-marker of tumor response secondary to AMPA blockade, advancing confirmation by MR imaging. These results warrant further study of PER on tumor activity in gliomas.
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Metadata
Title
Seizure response to perampanel in drug-resistant epilepsy with gliomas: early observations
Authors
Charles Vecht
Alberto Duran-Peña
Caroline Houillier
Thomas Durand
Laurent Capelle
Gilles Huberfeld
Publication date
01-07-2017
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 3/2017
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-017-2473-1

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