Refractory nonconvulsive status epilepticus (NCSE) occurs in 10%-30% of patients following resuscitation after cardiac arrest. Both the optimal treatment and prognosis of postanoxic status epilepticus remain uncertain. We analyzed acute electroencephalographic changes, neurological outcome at 3 months, and adverse effects in consecutive postanoxic patients with super-refractory NCSE treated with add-on oral loading of perampanel. Eight postanoxic patients with super-refractory NCSE were treated with perampanel (dose range = 6-12 mg). All patients had continuous electroencephalographic monitoring showing definite generalized NCSE and favorable multimodal prognostic indicators (presence of brainstem reflexes, presence of bilateral N20 responses, absence of periodic discharges/generalized epileptic periodic discharges). In six patients (75%), status epilepticus resolved within 72 hours after administration of perampanel, without changing the comedication. Neurological outcomes at 3 months were return to normal or minimal disability in four patients (50%). A mild cholestatic liver injury, which required no specific treatment, was observed in five patients (62.5%). Perampanel 6-12 mg oral loading appeared to be an effective option in selected patients with postanoxic super-refractory NCSE with good prognostic indicators. In this patient population, our safety data indicate a risk of cholestasis.

Beretta, S., Padovano, G., Stabile, A., Coppo, A., Bogliun, G., Avalli, L., et al. (2018). Efficacy and safety of perampanel oral loading in postanoxic super-refractory status epilepticus: A pilot study. EPILEPSIA, 59, 243-248 [10.1111/epi.14492].

Efficacy and safety of perampanel oral loading in postanoxic super-refractory status epilepticus: A pilot study

Padovano G.;Stabile A.;Coppo A.;Avalli L.;Ferrarese C.
2018

Abstract

Refractory nonconvulsive status epilepticus (NCSE) occurs in 10%-30% of patients following resuscitation after cardiac arrest. Both the optimal treatment and prognosis of postanoxic status epilepticus remain uncertain. We analyzed acute electroencephalographic changes, neurological outcome at 3 months, and adverse effects in consecutive postanoxic patients with super-refractory NCSE treated with add-on oral loading of perampanel. Eight postanoxic patients with super-refractory NCSE were treated with perampanel (dose range = 6-12 mg). All patients had continuous electroencephalographic monitoring showing definite generalized NCSE and favorable multimodal prognostic indicators (presence of brainstem reflexes, presence of bilateral N20 responses, absence of periodic discharges/generalized epileptic periodic discharges). In six patients (75%), status epilepticus resolved within 72 hours after administration of perampanel, without changing the comedication. Neurological outcomes at 3 months were return to normal or minimal disability in four patients (50%). A mild cholestatic liver injury, which required no specific treatment, was observed in five patients (62.5%). Perampanel 6-12 mg oral loading appeared to be an effective option in selected patients with postanoxic super-refractory NCSE with good prognostic indicators. In this patient population, our safety data indicate a risk of cholestasis.
Articolo in rivista - Articolo scientifico
perampanel; postanoxic; prognosis; refractory status epilepticus;
English
243
248
6
Beretta, S., Padovano, G., Stabile, A., Coppo, A., Bogliun, G., Avalli, L., et al. (2018). Efficacy and safety of perampanel oral loading in postanoxic super-refractory status epilepticus: A pilot study. EPILEPSIA, 59, 243-248 [10.1111/epi.14492].
Beretta, S; Padovano, G; Stabile, A; Coppo, A; Bogliun, G; Avalli, L; Ferrarese, C
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/279736
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