Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Case Report Volume 7 Issue 2

Non-hepatic Hyperammonemia with Loading Dose of Perampanel in a Case of CNS Lupus Presenting with Non-Convulsive Status Epilepticus

Rahul Ghiya*, Sanghita Layek and A Shobana

Department of Neurocritical Care, Institute of Neuroscience, Kolkata, West Bengal, India

*Corresponding Author: Rahul Ghiya, Department of Neurocritical Care, Institute of Neuroscience, Kolkata, West Bengal, India.

Received: January 11, 2024; Published: January 31, 2024


Hyperammonemia manifests clinically as mild cognitive impairment to coma and even death. It happens due to both hepatic metabolic disorders or non-hepatic causes. Perampanel is an antiepileptic drug metabolized by hepatic enzymes.We here report a patient of CNS lupus who presented with NCSE and developed hyperammonemia after receiving the loading dose of perampanel. No definite mechanism has been able to explain the correlation between perampanel and hyperammonemia. The blood ammonia levels came down to the normal range after stopping the medication. However, even after the stoppage of perampanel and normalization of ammonia, her condition and NCSE remains the same. We suggest serum ammonia levels should be done before starting perampanel in any patient with a constant monitoring of ammonia levels at regular intervals. However, more cases are required to understand the mechanism of action, risk factors and establish monitoring protocols in patients for perampanel therapy.

Keywords: Hyperammonemia; Perampanel; NCSE; Neurological Manifestations


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Citation: Rahul Ghiya., et al. “Non-hepatic Hyperammonemia with Loading Dose of Perampanel in a Case of CNS Lupus Presenting with Non-Convulsive Status Epilepticus". Acta Scientific Neurology 7.2 (2024): 46-49.


Copyright: © 2024 Rahul Ghiya., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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