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PER was administered preoperatively at 2\u20134\u00a0mg. On the day of surgery, an additional 2\u00a0mg of PER was given intravenously at the start of the procedure and another 2\u00a0mg upon completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 29 patients who underwent AC, five were excluded (four on multiple antiseizure medications and one who declined PER treatment), leaving 24 for analysis. Intraoperative seizures occurred in 3 patients (12.5%), all focal and controlled with cold saline irrigation. No intractable or generalized seizures occurred, and no awake procedures failed. Two patients had preoperative epilepsy, whereas one had no prior seizure history. Early postoperative seizures developed in 2 patients (8.3%), and complete seizure control was achieved in all patients by 3 months postoperatively. Treatment-related adverse effects occurred in one patient (4.2%) who developed a skin rash and discontinued PER. Among the 22 patients without early postoperative seizures, antiseizure medications were successfully discontinued within 6 months in 9 patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cohort, PER provided perioperative seizure control with a very low incidence of adverse effects. These preliminary findings support the feasibility of PER monotherapy and provide a rationale for prospective evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11060-026-05580-w","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T13:15:59Z","timestamp":1777036559000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of perampanel monotherapy for seizure management during awake craniotomy for glioma"],"prefix":"10.1007","volume":"177","author":[{"given":"Yuta","family":"Koketsu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoichi","family":"Deguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiharu","family":"Ohka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Aoki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Shiba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhei","family":"Takido","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeaki","family":"Nawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehito","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Akiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuta","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"5580_CR1","doi-asserted-by":"publisher","unstructured":"Kayama T, Guidelines committee of the Japan Awake Surgery Conference (2012) The guidelines for awake craniotomy: guidelines committee of the Japan awake surgery conference. 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