吡仑帕奈作用机制与治疗伴中央颞区棘波的自限性癫痫临床疗效的研究进展  

Research progress on the mechanism of action of perampanel and its clinical efficacy for self-limited epilepsy with centrotemporal spikes

作　　者：唐漆 田朝阳 李玲 TANG Qi;TIAN Chaoyang;LI Ling(Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Hubei University for Nationalities,Enshi 445000,China;Translational Medicine Center,Enshi Central Hospital,Enshi 445000 Hubei,China;Key Laboratory of Hubei Province,Hubei Institute of Selenium and Human Health,Enshi 445000,China)

机构地区：[1]湖北民族大学附属恩施土家族苗族自治州中心医院神经内科,恩施445000 [2]恩施州中心医院转化医学中心,恩施445000 [3]湖北硒与人体健康研究院湖北省重点实验室,恩施445000

出　　处：《癫痫杂志》2025年第2期158-162,共5页Journal of Epilepsy

摘　　要：抗癫痫发作药物是癫痫最重要和最基本的治疗手段,也是癫痫的治疗首选,但约1/3癫痫患者存在耐药。吡仑帕奈作为第三代新型抗癫痫发作药物,通过非竞争性抑制α-氨基-3-羟基-5-甲基-4-异恶唑啉丙酸受体(α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptor,AMPAR)发挥抗癫痫发作作用。2021年在我国获批上市以来,其主要应用于局灶性癫痫(伴或不伴全面性发作)的单药或添加治疗,且具有良好的安全、有效及耐受性。伴中央颞区棘波的自限性癫痫(self-limited epilepsy with centrotemporal spikes,SeLECTS)是一种常见的儿童期局灶性癫痫综合征,占各种儿童癫痫的15%~25%,在吡仑帕奈的临床研究中具有重要优势,并表现出一定疗效。同时,吡仑帕奈对认知的总体影响是中性的,没有系统性的认知恶化或改善。鉴于吡仑帕奈应用时间相对较短,尚属新药,该文将从吡仑帕奈的作用机制、剂量、添加(单药)治疗、不良事件等展开综述,以期为临床医师提供更多的药物选择参考,同时利于癫痫的个体化诊疗。Anti-seizure medications(ASMs)are the most important and basic treatment for epilepsy,and are also the first choice for epilepsy treatment,but about one-third of patients have drug resistance.Perampanel(PER),as a novel third generation ASMs,inhibits theα-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptor(AMPAR)through non-competitive inhibition.AMPA plays an anti-seizure role.Since its approval in China in 2021,it has been mainly used in the treatment of focal epilepsy(with or without general seizure)as a single drug or addition,and has good safety,effectiveness and tolerability.Self-limited epilepsy with centrotemporal spikes(SeLECTS)is a common childhood focal epilepsy syndrome,accounting for 15%~25%of various childhood epilepsies,PER has important advantages in clinical studies and has shown certain curative effect.At the same time,the overall effect of PER on cognition was neutral,with no systemic cognitive deterioration or improvement.In view of the relatively short application time of PER,which is still a new drug,this article will review the mechanism of action,dose,add-on(single drug)treatment,adverse events and,in order to provide clinicians with more drug choices and facilitate the individualized diagnosis and treatment of epilepsy.

关 键 词：吡仑帕奈 伴中央颞区棘波的自限性癫痫 局灶性癫痫 癫痫综合征 

分 类 号：R742.1[医药卫生—神经病学与精神病学]