We report a retrospective monocentric study performed on 63 patients affected by epilepsy with known
etiology, receiving perampanel as add-on therapy with at least 12-month follow-up. The purpose of our
study was to evaluate efficacy and tolerability of perampanel in this group of epilepsies. Patients were
classified into 2 groups based on the presence/absence of a single focal brain lesion on MRI, as epilepsy
etiology: 48 subjects were affected by focal lesional epilepsy and 15 by non-focal lesional epilepsy. The
retention rate was 76.2% and 53.9% at 12 and 24 months respectively. At 12 months, at least 40% of
patients resulted responders, with a significant reduction in seizure frequency (p = 0.01), confirmed at
24 months. Considering epilepsy etiology, we found a better PER response in patients with focal lesional
epilepsy. A significant correlation was observed between responder rates and EEG pattern. Only 30% of
patients reported mild-moderate adverse events. Efficacy and tolerability of PER, in our study, are in line
with the results reported in other real-world studies. Our data suggest the possibility of better PER
response in patients with focal brain lesions, which indicates that this drug could be a therapeutic option
in this population.
