Perampanel for Treatment of Adults With Refractory Focal Epilepsy : a Pilot Study.

Inclusion Criteria: 1. Age 18-65 2. Stable focal epilepsy, with partial complex seizures including partial complex seizures with or without secondary generalization, partial simple seizures with a clear motor component with or without secondary generalization, and partial simple seizures with secondary generalization. 3. Stable dose for at least 30 days of the chosen background AED dose 4. Epilepsy duration for \> 2 years 5. Past/current treatment with \> 4 AEDs. Vagal nerve stimulator treatment will be allowed and will not count as an AED. VNS setting must be stable for 3 months prior to enrollment. 6. Seizure frequency of ≥1/month Exclusion Criteria: 1. Primary generalized epilepsy 2. Simple partial seizures without motor components or secondary generalization 3. Non-epileptic seizures 4. Progressive neurological disease including growing neoplasm, CNS degenerative disorders including Alzheimer's disease, other forms of dementia 5. Any systemic illness or unstable medical condition that might pose additional risk, including renal or liver disease, clinically uncontrolled cardiac disease, other unstable metabolic or endocrine disturbances, and active systemic cancer 6. Change in the dose of any Antiepileptic Drug within 30 days prior to enrollment 7. Psychosis within six months of enrollment. 8. Active drug or alcohol dependence or any other factors that, in the opinion of the site investigators would interfere with adherence to study requirements; 9. Pregnancy 10. Use of any CNS-active investigational drugs within 3 months of enrollment. 11. Inability or unwillingness of subject or legal guardian/representative to give written informed consent.