Pediatric perampanel poisoning

Area of Science:

• Pediatric Neurology
• Clinical Toxicology
• Pharmacology

Background:

• Perampanel is an antiepileptic drug used to treat partial-onset seizures.
• Limited data exists regarding perampanel overdose, especially in pediatric populations.

Observation:

• Two cases of perampanel ingestion in 2-year-old children are presented.
• Case 1: Female ingested 0.77mg/kg, developing drowsiness and ataxia within 1 hour, followed by bradycardia at 6 hours. Required pediatric intensive care unit admission and fluid treatment.
• Case 2: Male ingested 0.25mg/kg, developing ataxia within 1 hour. Discharged after 6-hour emergency department observation without treatment.

Findings:

• Pediatric perampanel overdose can lead to significant neurological symptoms like ataxia and drowsiness.
• Bradycardia is a potential complication, even with moderate doses.
• Severity of symptoms may correlate with the ingested dose.

Implications:

• Highlights the need for increased awareness of perampanel toxicity in children.
• Suggests that even accidental pediatric ingestions warrant medical evaluation.
• Informs clinical management guidelines for perampanel overdose in young children.