Journal
CLINICAL NEUROPHYSIOLOGY
Volume 130, Issue 10, Pages 1804-1812Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.clinph.2019.07.006
Keywords
Progressive myoclonus epilepsy; Somatosensory-evoked potential; Primary motor area; Paroxysmal depolarization shift; Excitatory postsynaptic potential
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Funding
- Japan Society for the Promotion of Science (JSPS) [23591275, 15H05874]
- Grants-in-Aid for Scientific Research [23591275] Funding Source: KAKEN
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Objective: To elucidate the effects of perampanel (PER) on refractory cortical myoclonus for dose, etiology and somatosensory-evoked potential (SEP) findings. Methods: We examined 18 epilepsy patients with seizure and cortical myoclonus. Based on data accumulated before and after PER treatment, correlations among clinical scores in myoclonus and activities of daily life (ADL); early cortical components of SEP; and PER blood concentration, were analyzed. Results: PER (mean dose: 3.2 +/- 2.1 mg/day) significantly improved seizures, myoclonus and ADL and significantly decreased the amplitude of and prolonged latency of giant SEP components. The degree of P25 and N33 prolongations (23.8 +/- 1.6 to 24.7 +/- 1.7 ms and 32.1 +/- 4.0 to 33.7 +/- 3.4 ms) were significantly correlated with improved ADL score (p = 0.019 and p = 0.025) and blood PER concentration (p = 0.011 and p = 0.025), respectively. Conclusions: Low-dose PER markedly improved myoclonus and ADL in patients with refractory cortical myoclonus. Our results suggest that SEP, particularly P25 latency, can be used as a potential biomarker for assessing the objective effects of PER on intractable cortical myoclonus. Significance: In this study, PER lessened the degree of synchronized discharges in the postsynaptic neurons in the primary motor cortex. (C) 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.
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