Perampanel (PER) is a novel class of anti-seizure medication and selective, non-competitive inhibitor of the α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptor. We investigated the efficacy and safety of PER as a first-line monotherapy over a long period of time (30 months), as well as its impact on QOL, and will provide an interim report at 12 months. We studied 61 patients aged 4 years and older who were diagnosed with new-onset or recurrent epilepsy with focal-onset seizures and started treatment with PER alone. The dose of PER in actual clinical practice at 12 months of treatment may be low, suggesting that initiation and maintenance of a low dose may be effective in reducing neurological side effects, especially. The results suggest that the efficacy, retention rate and safety of PER are similar to those reported at the time of clinical trials and in clinical practice in other countries. Furthermore, no deterioration in the QOL of patients or their guardians was observed. These findings highlight the importance of PER as a clinical treatment option for newly diagnosed patients with epilepsy, including children and older adults.

The girl was diagnosed with autism spectrum disorder at 3 years of age. At 6 years of age, she was diagnosed with epilepsy with eyelid myoclonia based on abnormal electroencephalogram (EEG) findings and eyelid myoclonia induced by eye closure. Although she was treated with multiple antiepileptic medications such as valproic acid, lamotrigine, and perampanel, abnormal EEG findings persisted, and the developmental quotient (DQ) score declined.

Epilepsy with eyelid myoclonia is a rare disease but an important syndrome that should not be overlooked. Children with autism spectrum disorder (ASD) have a higher incidence of epilepsy than those without ASD. Early intervention for epilepsy and EEG abnormalities in infancy is important because they may interfere with the development of brain function. EEG evaluation should be considered for children with ASD, atypical findings such as eyelid myoclonia, or intellectual disabilities.