Possible effect of perampanel on focal status epilepticus after generalized tonic–clonic status epilepticus

Since in refractory status epilepticus (SE), additional glutamate receptors such as alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and N-methyl-d-aspartate (NMDA) receptors are built up in the synaptic membrane [1], perampanel, a novel noncompetitive AMPA-receptor antagonist, may be effective in this condition. During the treatment of refractory SE, usually a combination therapy of several antiepileptic drugs (AEDs) is established. Therefore, the drug, which has terminated the SE, cannot easily be identified. A possible effect of an AED on the termination of a SE may be supposed, when the termination of a SE is associated with the introduction of an AED in the therapy or an increased dose of an AED in combination with other changes in the antiepileptic medication at the same time [2]. Here we present a case where perampanel was the last AED introduced in the treatment of a focal SE before its termination 24 h later.