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Pregnancy epilepsy

Sophie Dupont
Catamenial epilepsy, defined as the exacerbation of the frequency of seizures in a given phase of the menstrual cycle, affects 35% of women. In women with catamenial epilepsy with perimenstrual seizures, progesterone therapy may be effective. In case of enzyme inducer AEDs, hormonal contraception is deprecated (estroprogestative or progestative pill, progestative implant, patches or hormonal rings). Because of its high malformative teratogenic potential, its possible depressive cognitive effects and the autistic risk, sodium valproate is not indicated during pregnancy...
March 8, 2018: La Presse Médicale
Dana Jazayeri, Janet Graham, Alison Hitchcock, Terence J O'Brien, Frank J E Vajda
PURPOSE: Antiepileptic drugs (AEDs), particularly valproate (VPA), are known to be teratogens when taken by women with epilepsy (WWE), but the risk in women who take these drugs for indications other than epilepsy have been little studied. This study aims to investigate the incidence of birth defects in children born to mothers taking AEDs for non-epilepsy indications. METHODS: The Australian Pregnancy Register (APR), established in 1998, is a prospective observational study operating with ethical approval and informed written consent for participation...
February 17, 2018: Seizure: the Journal of the British Epilepsy Association
Lars Skou Elkjær, Bodil Hammer Bech, Yuelian Sun, Thomas Munk Laursen, Jakob Christensen
Importance: Valproate sodium is used for the treatment of epilepsy and other neuropsychiatric disorders in women of childbearing potential. However, there are concerns about impaired cognitive development in children who have been exposed to valproate during pregnancy. Objective: To estimate the association between long-term school performance and prenatal exposure to valproate and a number of other antiepileptic drugs (AEDs). Design, Setting, and Participants: In a prospective, population-based cohort study conducted from August 1, 2015, to May 31, 2017, data used in the study were provided by Statistics Denmark on April 15, 2016...
February 19, 2018: JAMA Neurology
Cecilie Johannessen Landmark, Anette Huuse Farmen, Margrete Larsen Burns, Arton Baftiu, Morten I Lossius, Svein I Johannessen, Torbjörn Tomson
BACKGROUND AND PURPOSE: Use of valproate (VPA) in women of childbearing age is restricted due to dose-dependent risk of teratogenicity. The purpose of this study was to characterise pharmacokinetic variability of VPA in pregnancy, and discuss use of therapeutic drug monitoring (TDM) as guidance to exposure in women. METHOD: Measurements of trough total and unbound VPA concentrations before, during and after pregnancy, at assumed steady-state were collected from the TDM-database (2006-2016) at the National Center for Epilepsy in Norway...
February 11, 2018: Epilepsy Research
Martina Persson, Neda Razaz, Kristina Tedroff, K S Joseph, Sven Cnattingius
OBJECTIVE: To investigate associations between Apgar score at five and 10 minutes across the entire range of score values (from 0 to 10) and risks of childhood cerebral palsy or epilepsy, and to analyse the effect of changes in Apgar scores from five to 10 minutes after birth in infants born ≥37 completed weeks. DESIGN, SETTING, AND PARTICIPANTS: Population based cohort study in Sweden, including 1 213 470 non-malformed live singleton infants, born at term between 1999 and 2012...
February 7, 2018: BMJ: British Medical Journal
Ravish R Keni, Manna Jose, Prabhakaran Sankara Sarma, Sanjeev V Thomas
OBJECTIVE: To determine the relative risk (RR) of major congenital malformations (MCMs) in infants with antenatal exposure to antiepileptic drug (AED) dual therapy and to explore the influence of specific AEDs vs dose. METHODS: All completed pregnancies prospectively enrolled in the Kerala Registry of Epilepsy and Pregnancy from 1998 until December 2013 on AED dual therapy exposure during the first trimester were analyzed for the outcome, MCMs. Dose was expressed as ratio of prescribed to daily defined dose (PDD/DDD), and the RR for malformation was referenced to lamotrigine monotherapy...
February 2, 2018: Neurology
Latica Friedrich, Ana Sruk, Ivan Bielen
Pregnancy-related issues in epilepsy (PRIE) are essential for management of epilepsy in women. We conducted a study among women with epilepsy (WWE) aged 15-45years about their knowledge, sources, and needs for information regarding PRIE, which included their current antiepileptic drugs (AEDs) usage. Women with epilepsy, visitors of Croatian Association for Epilepsy webpage, were offered an online questionnaire, and 200 responses were analyzed. The mean number of correct answers about PRIE was 3.5 out of 5. Main predictors of knowledge on PRIE were a prior consultation with a neurologist and higher usage of books/brochures...
February 1, 2018: Epilepsy & Behavior: E&B
Rangan Srinivasaraghavan, Narayanan Parameswaran, Deborah Mathis, Celine Bürer, Barbara Plecko
Antiquitin deficiency is the most prevalent form of pyridoxine-dependent epilepsy. While most patients present with neonatal onset of therapy-resistant seizures, a few cases with late-onset during infancy have been described. Here, we describe the juvenile onset of epilepsy at the age of 17 years due to antiquitin deficiency in an Indian female with homozygosity for the most prevalent ALDH7A1 missense mutation, c.1279G > C; p.Glu427Gln in exon 14. The diagnosis was established along familial cosegregation analysis for an affected offspring, that had neonatal pyridoxine responsive seizures and had been found to be compound heterozygous for c...
February 5, 2018: Neuropediatrics
Vaiva Petrenaite, Inger Öhman, Lena Ekström, Ditte Sæbye, Thomas Folkmann Hansen, Torbjörn Tomson, Anne Sabers
OBJECTIVE: To evaluate the impact of maternal UGT1A4 and UGT2B7 genetic polymorphisms and sex of foetus on gestation-induced changes in lamotrigine (LTG) clearance during pregnancy and post-partum (PP). METHODS: Single nucleotide polymorphisms UGT1A4 142T > G, L48V (*3), UGT1A4 70C > A, P24T (*2) and UGT2B7 802C > T, H268Y (*2) were determined in 40 women (47 pregnancies) with epilepsy treated with LTG. Retrospectively collected data included LTG dosage and LTG plasma levels before pregnancy (T0), and LTG dosage and LTG plasma level changes in the first (T1), second (T2) and third trimester (T3), and post-partum (PP) as well as the sex of the foetus...
January 30, 2018: Epilepsy Research
Keling Wang, Xiaopan Chen, Jie Liu, Li-Ping Zou, Wenke Feng, Lu Cai, Xiaoyang Wu, Shao-Yu Chen
Prenatal ethanol exposure is known to cause neurodevelopmental disorders. While high prevalence of epilepsy is observed among the children whose mothers abused alcohol during pregnancy, the results from animal studies are conflicting. Here, we investigated whether embryonic exposure to ethanol can increase the susceptibility to pentylenetetrazole (PTZ)-induced seizures in larval zebrafish. Embryos at 3 hours post-fertilization (hpf) were exposed to ethanol at the concentrations ranging from 0.25% to 1% for 21 hours...
January 30, 2018: Scientific Reports
Ma Del Rosario Cruz-Cruz, Jorge Gallardo-Elías, Sergio Paredes-Solís, José Legorreta-Soberanis, Miguel Flores-Moreno, Neil Andersson
BACKGROUND: Epilepsy is the most common chronic neurological disease in the world. In Mexico, epilepsy is among the diseases more related to mortality due to non-infectious diseases in children. The objective of the study was to identify the factors associated with epilepsy in children entitled to the Mexican Social Security Institute (IMSS), in Acapulco, Mexico. METHODS: We carried out a case-control study from April 2010 to April 2011. We selected 118 cases from the database of outpatient pediatric neurology with epilepsy diagnostic with two year of evolution according to the International League Against Epilepsy criteria...
September 2017: Boletín Médico del Hospital Infantil de México
E Aldasoro, E Posada, A Requena-Méndez, A Calvo-Cano, N Serret, A Casellas, S Sanz, D Soy, M J Pinazo, J Gascon
Background: Benznidazole is one of the two most effective antiparasitic drugs for Chagas' disease treatment. However, knowledge about its toxicity profile is mostly based on post-marketing observational studies. Objectives: Our study combines data from two prospective clinical trials designed to assess the safety of the drug newly produced by ELEA Laboratories (Abarax®). Methods: Eligible participants were selected using a consecutive sampling strategy in the CINEBENZ and BIOMARCHA studies between 2013 and 2016 (EUDRACT 2011-002900-34 and 2012-002645-38, respectively, and clinicaltrials...
January 16, 2018: Journal of Antimicrobial Chemotherapy
Bei Jia, Liping Huang, Yaoyu Chen, Siping Liu, Cuihua Chen, Ke Xiong, Lanlin Song, Yulai Zhou, Xinping Yang, Mei Zhong
Contiguous microdeletions of the Norrie disease pseudoglioma (NDP) region on chromosome Xp11.3 have been widely confirmed as contributing to the typical clinical features of Norrie disease (ND). However, the precise relation between genotype and phenotype could vary. The contiguous deletion of NDP and its neighbouring genes, MAOA/B and EFHC2, reportedly leads to syndromic clinical features such as microcephaly, intellectual disability, and epilepsy. Herewe report a novel contiguous microdeletion of the NDP region containing the MAOB and EFHC2 genes,which causes eye defects but no cognitive disability...
December 2017: Journal of Genetics
Rolv Terje Lie, Dag Moster, Per Strand, Allen James Wilcox
Ionizing radiation at high doses early in life may cause neurodevelopmental problems. Possible effects of lower doses are, however, controversial. We use carefully collected exposure data for Norway following the Chernobyl accident in April 1986 combined with population-based registries to assess long-term effects of fetal exposure on neurodevelopmental outcomes. Radiation doses were estimated for each Norwegian municipality for each calendar month from May 1986 to April 1989. We established a cohort of all Norwegian pregnancies during the three-year period of radiation measurement and compared them with appropriate unexposed groups...
December 2017: European Journal of Epidemiology
Laurent M Willems, Johann Philipp Zöllner, Esther Paule, Susanne Schubert-Bast, Felix Rosenow, Adam Strzelczyk
Eslicarbazepine acetate (ESL) is a third-generation antiepileptic drug (AED) approved for adjunctive treatment in adults, children, and adolescents with focal-onset seizures. Recently ESL was approved for initial monotherapy in adults. The intention of this article is to review current evidence for ESL and to summarise its pharmacological profile in comparison to other AEDs of the dibenzazepine group. Areas covered: We performed a systematic literature search in electronic databases (MEDLINE database, Cochrane Central Register of Controlled Trials, Excerpta Medica dataBASE) using a combined search strategy including the following keywords: eslicarbazepine, epilepsy and seizure...
December 29, 2017: Expert Review of Clinical Pharmacology
Jian Zhang, Yiting Hu, Jimin Zheng, Juncha Gao, Hongtao Hou, Na Liu, Yuzhen Wang
Acute intermittent porphyria (AIP) is a rare inherited disorder of heme metabolism. It has the ability to trigger posterior reversible encephalopathy syndrome (PRES), a rare acute neurologic condition that is characterized by acute neurological symptoms. Pregnancy may induce AIP attacks. The present report describes the case of a pregnant woman with AIP. The patient was treated with heme-arginate during pregnancy and successfully delivered a healthy baby. Following delivery, the patient presented with PRES and experienced generalized seizures...
December 2017: Experimental and Therapeutic Medicine
Sonia Hernandez-Diaz, Krista F Huybrechts, Rishi J Desai, Jacqueline M Cohen, Helen Mogun, Page B Pennell, Brian T Bateman, Elisabetta Patorno
OBJECTIVE: To assess the relative risk of oral clefts associated with maternal use of high and low doses of topiramate during the first trimester for epilepsy and nonepilepsy indications. METHODS: This population-based study nested in the US 2000-2010 Medicaid Analytic eXtract included a cohort of 1,360,101 pregnant women with a live-born infant enrolled in Medicaid from 3 months before conception through 1 month after delivery. Oral clefts were defined as the presence of a recorded diagnosis in claims during the first 90 days after birth...
January 23, 2018: Neurology
Marte Bjørk, Bettina Riedel, Olav Spigset, Gyri Veiby, Eivind Kolstad, Anne Kjersti Daltveit, Nils Erik Gilhus
Importance: Strategies to prevent autism in children exposed to antiepileptic drugs (AEDs) during pregnancy are important. Objective: To explore whether folic acid supplementation and folate status in pregnancy are associated with reduced risk of autistic traits owing to in utero AED exposure. Design, Setting, and Participants: The population-based, prospective Norwegian Mother and Child Cohort Study approached Norwegian-speaking women attending routine ultrasonographic examinations from June 1999 through December 31, 2008 (163 844 of 277 702 women refused)...
December 26, 2017: JAMA Neurology
Anne Mette Lund Würtz, Claus Høstrup Vestergaard, Dorte Rytter, Merete Juul Sørensen, Jakob Christensen, Mogens Vestergaard, Bodil Hammer Bech
Background: Antipsychotic (AP) medication is increasingly used for many health conditions. Prenatal exposure to AP medication has been associated with several adverse outcomes, but the findings remain inconsistent. Purpose: We aimed to investigate prenatal exposure to AP medication and the use of primary health care system in childhood. Subjects and methods: All live-born singletons in Denmark during 1997-2012 were identified in the nationwide Danish National Patient Register and followed until December 31, 2013 (n = 963,010)...
2017: Clinical Epidemiology
Carolin Dierking, Thomas Porschen, Uwe Walter, Johannes Rösche
There are several issues, which have to be acknowledged, when treating women with epilepsy (WWE). The need for counseling WWE in Germany with epilepsy on pregnancy-related matters was stressed in several papers and medical guidelines. Physicians treating WWE in Germany therefore should be aware of the information needs of their patients. We aimed to determine the level of pregnancy-related knowledge of WWE and their informational needs concerning pregnancy and childbirth issues in German-speaking countries by an internet-based survey...
February 2018: Epilepsy & Behavior: E&B
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