Infection-Induced Elevated Plasma Perampanel in a Patient with Hemimegalencephaly
Perampanel is a noncompetitive, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid glutamate receptor antagonist. Herein, we report a case of increased perampanel plasma concentration and impaired consciousness triggered by an infection. The patient had refractory epilepsy associated with hemimega...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2022/9844820 |
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| author | Yuya Kinoshita Hiroe Ueno Hirofumi Kurata Chizuru Ikeda Erika Hori Takumi Okada Tomoyuki Shimazu Isao Fujii Makoto Matsukura Hoseki Imamura |
| author_facet | Yuya Kinoshita Hiroe Ueno Hirofumi Kurata Chizuru Ikeda Erika Hori Takumi Okada Tomoyuki Shimazu Isao Fujii Makoto Matsukura Hoseki Imamura |
| author_sort | Yuya Kinoshita |
| collection | DOAJ |
| description | Perampanel is a noncompetitive, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid glutamate receptor antagonist. Herein, we report a case of increased perampanel plasma concentration and impaired consciousness triggered by an infection. The patient had refractory epilepsy associated with hemimegalencephaly. During adolescence, perampanel (maximum dose, 10 mg, oral), valproic acid, clobazam, and lacosamide were administered for seizure control. He was admitted to our hospital with high fever, impaired consciousness, and elevated perampanel plasma level (from 1,300 to 1,790 ng/mL), but with no increase in the concentration of other antiseizure medications. Further examinations (blood, cerebrospinal fluid, brain magnetic resonance images, and electroencephalogram) revealed no physical cause for impaired consciousness. After discontinuation of perampanel, his level of consciousness gradually improved. The pharmacokinetics of perampanel may be modified by both hemimegalencephaly and infection, resulting in an elevated plasma concentration of perampanel. This case underlines the importance of monitoring perampanel plasma concentration in patients with underlying brain disease who develop an infection. |
| format | Article |
| id | doaj-art-384bd0ee364b446ca508498ca434be4f |
| institution | Kabale University |
| issn | 2090-6811 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-384bd0ee364b446ca508498ca434be4f2025-02-03T06:07:34ZengWileyCase Reports in Pediatrics2090-68112022-01-01202210.1155/2022/9844820Infection-Induced Elevated Plasma Perampanel in a Patient with HemimegalencephalyYuya Kinoshita0Hiroe Ueno1Hirofumi Kurata2Chizuru Ikeda3Erika Hori4Takumi Okada5Tomoyuki Shimazu6Isao Fujii7Makoto Matsukura8Hoseki Imamura9National Hospital Organization Kumamoto Saishun Medical CenterNational Hospital Organization Kumamoto Saishun Medical CenterNational Hospital Organization Kumamoto Saishun Medical CenterNational Hospital Organization Kumamoto Saishun Medical CenterAso Medical CenterKumamoto Kenhoku HospitalNational Hospital Organization Kumamoto Saishun Medical CenterArao Municipal HospitalKumamoto-Ashikita Center for The Severely DisabledNational Hospital Organization Kumamoto Saishun Medical CenterPerampanel is a noncompetitive, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid glutamate receptor antagonist. Herein, we report a case of increased perampanel plasma concentration and impaired consciousness triggered by an infection. The patient had refractory epilepsy associated with hemimegalencephaly. During adolescence, perampanel (maximum dose, 10 mg, oral), valproic acid, clobazam, and lacosamide were administered for seizure control. He was admitted to our hospital with high fever, impaired consciousness, and elevated perampanel plasma level (from 1,300 to 1,790 ng/mL), but with no increase in the concentration of other antiseizure medications. Further examinations (blood, cerebrospinal fluid, brain magnetic resonance images, and electroencephalogram) revealed no physical cause for impaired consciousness. After discontinuation of perampanel, his level of consciousness gradually improved. The pharmacokinetics of perampanel may be modified by both hemimegalencephaly and infection, resulting in an elevated plasma concentration of perampanel. This case underlines the importance of monitoring perampanel plasma concentration in patients with underlying brain disease who develop an infection.http://dx.doi.org/10.1155/2022/9844820 |
| spellingShingle | Yuya Kinoshita Hiroe Ueno Hirofumi Kurata Chizuru Ikeda Erika Hori Takumi Okada Tomoyuki Shimazu Isao Fujii Makoto Matsukura Hoseki Imamura Infection-Induced Elevated Plasma Perampanel in a Patient with Hemimegalencephaly Case Reports in Pediatrics |
| title | Infection-Induced Elevated Plasma Perampanel in a Patient with Hemimegalencephaly |
| title_full | Infection-Induced Elevated Plasma Perampanel in a Patient with Hemimegalencephaly |
| title_fullStr | Infection-Induced Elevated Plasma Perampanel in a Patient with Hemimegalencephaly |
| title_full_unstemmed | Infection-Induced Elevated Plasma Perampanel in a Patient with Hemimegalencephaly |
| title_short | Infection-Induced Elevated Plasma Perampanel in a Patient with Hemimegalencephaly |
| title_sort | infection induced elevated plasma perampanel in a patient with hemimegalencephaly |
| url | http://dx.doi.org/10.1155/2022/9844820 |
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