Early Add-on Perampanel in the Treatment of Focal Epilepsy: Experience from Clinical Cases

Abstract

This article describes the early add-on use of perampanel (PER) in the treatment of focal epilepsy through two clinical cases from Nguyen Tri Phuong Hospital. In both patients, adding PER after inadequate seizure control with monotherapy resulted in seizure freedom for at least six months using low doses (2–4 mg/day) with good tolerability. The authors also review current evidence supporting the effectiveness of PER as an early add-on therapy and emphasize the importance of initiating treatment at a low dose, slow titration, and careful monitoring for adverse effects, particularly psychiatric symptoms. Early add-on PER represents a promising strategy for optimizing seizure control in patients with focal epilepsy.