Infection-Induced Elevated Plasma Perampanel in a Patient with Hemimegalencephaly
Yuya Kinoshita1,2, Hiroe Ueno1,3, Hirofumi Kurata1
1National Hospital Organization Kumamoto Saishun Medical Center, Department of Pediatrics, Koshi, Japan.
Case Reports in Pediatrics
|May 9, 2022
Summary
An infection can increase perampanel levels in patients with brain conditions, leading to confusion. Monitoring perampanel (an epilepsy drug) levels during illness is crucial for patient safety.
Area of Science:
- Pharmacology
- Neurology
- Clinical Medicine
Background:
- Perampanel is an antiepileptic drug targeting glutamate receptors.
- The patient had refractory epilepsy and hemimegalencephaly.
- Treatment included perampanel, valproic acid, clobazam, and lacosamide.
Observation:
- A patient with epilepsy and hemimegalencephaly developed impaired consciousness during an infection.
- Perampanel plasma concentration increased significantly (1,300 to 1,790 ng/mL).
- Other antiseizure medication levels remained stable.
Findings:
- Infection and hemimegalencephaly likely altered perampanel pharmacokinetics.
- Elevated perampanel levels correlated with impaired consciousness.
- Discontinuation of perampanel led to gradual improvement in consciousness.
Implications:
- Highlights the importance of monitoring perampanel levels in patients with brain disease during infections.
- Suggests potential drug-drug-disease interactions affecting perampanel.
- Informs clinical practice for managing epilepsy in complex neurological conditions.
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