Objective:

To evaluate the clinical efficacy and safety of Perampanel (PER) as the initial monotherapy in pediatric epilepsy and investigate demographic, clinical, and treatment-related factors linked to its efficacy.

Key Findings:

• Seizure-free rate at 12 months was 64.1% (82/128 patients), with higher rates in the SeLECTS subgroup (78.6%, 33/42 patients).
• Efficacy rates of PER treatment were 92.9% at 6 months and 90.6% at 12 months.
• The average adverse events (AEs) rate was 24.8%, with common AEs being dizziness, drowsiness, and irritability.

Interpretation:

PER monotherapy proved effective and safe for children with epilepsy, with higher seizure-free rates observed in the SeLECTS subgroup compared to the non-SeLECTS subgroup, indicating potential benefits for specific patient populations.

Limitations:

• Single-center study may limit generalizability.
• Observational design does not allow for causal inferences, and potential biases may affect results.

Conclusion:

PER is an effective and safe initial treatment for pediatric patients with newly diagnosed epilepsy.