Prophylactic Administration of Perampanel for Post-Stroke Epilepsy (PROPELLER Study): A Trial Protocol

Area of Science:

• Neurology
• Clinical Pharmacology

Background:

• Post-stroke epilepsy significantly impairs daily living activities.
• Prophylactic antiepileptic drug use for post-stroke epilepsy is debated due to limited high-level evidence.
• Subcortical hemorrhage patients face the highest risk of developing post-stroke epilepsy.

Purpose of the Study:

• To evaluate the efficacy of prophylactic perampanel in preventing post-stroke epilepsy.
• To assess the impact of perampanel on epilepsy incidence in high-risk stroke patients.

Main Methods:

• Prospective, single-center, single-arm interventional study.
• Inclusion of patients with subcortical hemorrhage.
• Administration of 2 mg perampanel daily for one year, with a three-year total study period (including follow-up).
• Primary endpoint: development of epilepsy.

Main Results:

• Perampanel is anticipated to lower post-stroke epilepsy incidence compared to historical data.
• The study aims to provide preliminary data on perampanel's prophylactic potential.

Conclusions:

• Findings may offer new insights into preventing post-stroke epilepsy.
• The study's small size limits definitive conclusions but can inform larger clinical trials.
• Perampanel shows potential as a prophylactic agent for post-stroke epilepsy.