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seizures and pregnancy

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https://www.readbyqxmd.com/read/29778017/the-preconception-care-experiences-of-women-with-epilepsy-on-sodium-valproate
#1
Lorna Lawther, Helen Dolk, Marlene Sinclair, Jim Morrow
PURPOSE: To understand the preconception experiences of women with epilepsy who have been taking the teratogenic drug valproate. METHODS: Seven women were recruited, three from a preconception clinic and four from an antenatal clinic in a region of the UK. All had taken valproate preconceptionally. Three preconception clinic encounters were observed and audio-recorded. Interviews with all women were analysed using Interpretative Phenomenological Analysis (IPA). RESULTS: Women experienced a "trajectory of balance"...
May 16, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29753923/prevalence-of-valproate-syndrome-in-europe-from-2005-to-2014-a-registry-based-multi-centre-study
#2
Joan K Morris, Ester Garne, Maria Loane, Marie-Claude Addor, Ingeborg Barisic, Fabrizio Bianchi, Miriam Gatt, Monica Lanzoni, Catherine Lynch, Olatz Mokoroa, Vera Nelen, Amanda Neville, Mary T O'Mahony, Hanitra Randrianaivo-Ranjatoelina, Anke Rissmann, David Tucker, H E K de Walle, Nataliia Zymak-Zakutnia, Judith Ankin
Women with epilepsy need to continue to take anticonvulsants during their pregnancies to prevent seizures from occurring. Since the 1980's, it has been known that the use of valproate (an anticonvulsant) in the first trimester of pregnancy is associated with an increased risk of spina bifida. Recent studies have also demonstrated increased risks of other congenital anomalies as well as a risk of cognitive impairment. Doctors in the EU are now advised not to prescribe valproate in pregnant women, in women who can become pregnant or in girls unless other treatments are ineffective or not tolerated...
May 10, 2018: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/29751353/zonisamide-serum-concentrations-during-pregnancy
#3
Arne Reimers, Grethe Helde, Noémi Becser Andersen, Dag Aurlien, Elisabeth Surlien Navjord, Kathrine Haggag, Jakob Christensen, Kari Mette Lillestølen, Karl Otto Nakken, Eylert Brodtkorb
PURPOSE: To investigate the change in zonisamide (ZNS) serum concentration and its consequences in pregnant women with epilepsy. METHODS: Six hospitals in Norway and Denmark screened their records for women who had been using ZNS during pregnancy. Absolute serum concentrations as well as concentration/dose (CD)-ratios were compared to non-pregnant values. Descriptive data on seizure control and obstetrical data were also collected. RESULTS: 144 serum concentrations from 23 pregnancies in 15 individual women with epilepsy were included (six on monotherapy)...
May 4, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29747735/seizures-in-pregnancy
#4
REVIEW
Kassie J Bollig, Daniel L Jackson
Seizures are among the most serious neurologic complications encountered in pregnancy. This review provides a foundation for the initial diagnosis, evaluation, classification, and management of seizures during pregnancy.
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29737274/antiepileptic-drug-monitoring-in-pregnancy-empire-a-double-blind-randomised-trial-on-effectiveness-and-acceptability-of-monitoring-strategies
#5
Shakila Thangaratinam, Nadine Marlin, Sian Newton, Annalise Weckesser, Manny Bagary, Lynette Greenhill, Rachel Rikunenko, Maria D'Amico, Ewelina Rogozińska, Andrew Kelso, Kelly Hard, Jamie Coleman, Ngawai Moss, Tracy Roberts, Lee Middleton, Julie Dodds, Angela Pullen, Sandra Eldridge, Alexander Pirie, Elaine Denny, Doug McCorry, Khalid S Khan
BACKGROUND: Pregnant women with epilepsy on antiepileptic drugs (AEDs) may experience a reduction in serum AED levels. This has the potential to worsen seizure control. OBJECTIVE: To determine if, in pregnant women with epilepsy on AEDs, additional therapeutic drug monitoring reduces seizure deterioration compared with clinical features monitoring after a reduction in serum AED levels. DESIGN: A double-blind, randomised trial nested within a cohort study was conducted and a qualitative study of acceptability of the two strategies was undertaken...
May 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29727483/the-role-of-ethnicity-on-pregnancy-outcomes-in-women-with-epilepsy-the-need-for-specific-research
#6
Nanya Hao, Janet Graham, Alison Hitchcock, Terence J O'Brien, Frank J E Vajda
The role of ethnicity on pregnancy outcomes of women with epilepsy (WWE) has received little research attention but is important to guide management. The aim of this review is to identify and describe current knowledge of ethnicity for WWE giving birth. Literature searches were performed with the following terms: ethnic/race combined with epilepsy/seizure, antiepileptic drugs (AED), and/or pregnancy, and combined them with congenital malformation, birth outcome, or pregnancy complication, with English language restriction in PubMed, EMBASE, and Web of Science...
May 4, 2018: Epilepsia
https://www.readbyqxmd.com/read/29710218/fertility-and-birth-outcomes-in-women-with-epilepsy-seeking-pregnancy
#7
Page B Pennell, Jacqueline A French, Cynthia L Harden, Anne Davis, Emilia Bagiella, Evie Andreopoulos, Connie Lau, Nichelle Llewellyn, Sarah Barnard, Stephanie Allien
Importance: Prior studies report lower birth rates for women with epilepsy (WWE) but have been unable to differentiate between biological and social contributions. To our knowledge, we do not have data to inform WWE seeking pregnancy if their likelihood of achieving pregnancy is biologically reduced compared with their peers. Objective: To determine if WWE without a prior diagnosis of infertility or related disorders are as likely to achieve pregnancy within 12 months as their peers without epilepsy...
April 30, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29700085/valproate-life-saving-life-changing
#8
Rhys H Thomas
Antiepileptic medications, and valproate principally, are commonly prescribed teratogens. There is significant concern that we are not doing enough to educate clinicians and potential parents about the risks of valproate in pregnancy. There is clear advice from the Medicines and Healthcare products Regulatory Agency and the International League Against Epilepsy about the risks of valproate exposure in utero Reviews and guidelines that are focused on fetal risk, however, fall short in being able to fully replicate the complexity of a real clinical decision...
April 1, 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29689338/the-ketogenic-diet-in-disease-and-development
#9
REVIEW
Denis Barry, Sarah Ellul, Lindsey Watters, David Lee, Robert Haluska, Robin White
The ketogenic diet, low in carbohydrates and high in fat, was initially designed to reduce seizure onset in epilepsy. More recent evidence has shown its effectiveness in the treatment of movement and psychological disorders, and in general health maintenance. The cellular significance of ketone body metabolism during development and in the adult central nervous system is being revealed; however, the effects of replacing glucose with ketone bodies as the brains primary energy source especially in pregnancy are not fully understood...
April 21, 2018: International Journal of Developmental Neuroscience
https://www.readbyqxmd.com/read/29674237/eslicarbazepine-acetate-exposure-in-pregnant-women-with-epilepsy
#10
Raquel Costa, Luís M Magalhães, Joana Graça, Mariana Vieira, Helena Gama, Joana Moreira, José F Rocha, Patrício Soares-da-Silva
PURPOSE: Epilepsy is a common neurologic disorder requiring continued treatment during pregnancy. Treatment with antiepileptic drugs (AEDs) is needed for seizure control, but the risk of adverse events has to be minimized for both mother and foetus. Available data on pregnancy and foetal/postnatal outcomes following eslicarbazepine acetate (ESL) exposure via parent is herein presented for the first time. METHODS: ESL's global safety database was reviewed to identify pregnancy cases with exposure to ESL reported up to October 21st, 2017...
April 10, 2018: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/29674196/clinical-and-imaging-profile-of-patients-with-new-onset-seizures-a-presumptive-diagnosis-of-eclampsia-a-prospective-observational-study
#11
Vandana Bojja, Anish Keepanasseril, Pradeep P Nair, V C Sunitha
OBJECTIVE: To study the clinical and imaging profile of patients with new-onset seizures with a presumptive diagnosis of eclampsia. METHODS: This was a cross-sectional study, conducted in a tertiary teaching hospital, on pregnant women presenting with new onset seizures with presumptive diagnosis of eclampsia excluding those with pre-existing neurological conditions. Demographic details, medical and obstetric examination findings were noted. All women underwent neuroimaging within 5 days of onset seizures...
February 25, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29661537/pyridoxine-dependent-epilepsy-is-late-onset-a-predictor-for-favorable-outcome
#12
Rooy Rlp de, F J Halbertsma, E A Struijs, Spronsen Fj van, R J Lunsing, H M Schippers, Hasselt Pm van, B Plecko, G Wohlrab, S Whalen, J F Benoist, S Valence, P B Mills, L A Bok
AIM: In pyridoxine dependent epilepsy (PDE), patients usually present with neonatal seizures. A small subgroup is characterized by late-onset beyond 2 months of age. We aim to analyze the observation of relatively good cognitive outcome in this subgroup of late-onset PDE patients. METHODS: We retrospectively analyzed data from four metabolically and genetically confirmed late-onset patients with PDE due to antiquitin (ALDH7A1) deficiency. Data were analyzed regarding ALDH7A1 mutations, alpha-Aminoadipic semialdehyde (α-AASA) and pipecolic acid (PA) levels, medication during pregnancy, delivery, treatment delay, amount of seizures, pyridoxine dose, adjuvant therapy and findings on brain MRI...
March 30, 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29625362/epilepsy-related-concerns-among-patients-with-epilepsy-in-west-china
#13
Jiani Chen, Qian Li, Xin Tong, Minglian Su, Chiyi Wang, Dong Zhou
PURPOSE: In the present study, we aimed to investigate patient-derived epilepsy-related concerns among Chinese individuals with epilepsy and the impact of seizure control on patient concerns. METHODS: All adult patients with epilepsy who had visited the outpatient clinic at West China Hospital between July 2014 and June 2016 were invited to participate in the study. All patients were given a blank sheet of paper and asked to list any concerns they had regarding their disease in order of importance...
April 3, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29621911/incidence-and-natural-history-of-preeclampsia-eclampsia-at-the-university-maternity-of-antananarivo-madagascar-high-prevalence-of-the-early-onset-condition
#14
Andriamanetsiarivo Tanjona Ratsiatosika, Eric Razafimanantsoa, Valéry Bruno Andriantoky, Noël Ravoavison, Rakotovao Andrianampanalinarivo Hery, Malik Boukerrou, Silvia Iacobelli, Pierre-Yves Robillard
OBJECTIVES: To investigate the incidence of early - (delivery < 34 weeks) (EOP) versus late-onset (delivery ≥ 34 weeks) (LOP) in Madagascar. STUDY DESIGN: Eight months observational study of all preeclamptic/eclamptic women delivering at the maternity of the University Hospital of Befelatanana, Antananarivo, Madagascar. Sociodemographical and obstetrical risk factors are analysed. RESULTS: Over the study period, we found 142 combined preeclampsia/eclampsia among 4316 births (incidence 3...
April 5, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29610328/ectopic-neurogenesis-induced-by-prenatal-antiepileptic-drug-exposure-augments-seizure-susceptibility-in-adult-mice
#15
Atsuhiko Sakai, Taito Matsuda, Hiroyoshi Doi, Yukiko Nagaishi, Kiyoko Kato, Kinichi Nakashima
Epilepsy is a neurological disorder often associated with seizure that affects ∼0.7% of pregnant women. During pregnancy, most epileptic patients are prescribed antiepileptic drugs (AEDs) such as valproic acid (VPA) to control seizure activity. Here, we show that prenatal exposure to VPA in mice increases seizure susceptibility in adult offspring through mislocalization of newborn neurons in the hippocampus. We confirmed that neurons newly generated from neural stem/progenitor cells (NS/PCs) are integrated into the granular cell layer in the adult hippocampus; however, prenatal VPA treatment altered the expression in NS/PCs of genes associated with cell migration, including CXC motif chemokine receptor 4 ( Cxcr4 ), consequently increasing the ectopic localization of newborn neurons in the hilus...
April 17, 2018: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29588970/prevalence-risk-factors-and-neurobehavioral-comorbidities-of-epilepsy-in-kenyan-children
#16
Charles J Kind, Charles R J C Newton, Symon M Kariuki
Objective: To investigate the prevalence, risk factors, clinical features, and neurobehavioral comorbidities of epilepsy and acute symptomatic seizures in school-aged children in Kilifi, Kenya. Methods: Randomly selected children (N = 11,223) were screened for epilepsy and other neurodevelopmental disorders. Those who screened positive were invited for further clinical, electroencephalographic (EEG), and neuropsychological evaluations. Prevalence was measured by dividing cases by screened population, providing Agresti-Coull confidence intervals (CIs)...
December 2017: Epilepsia Open
https://www.readbyqxmd.com/read/29588327/educational-attainment-of-children-born-to-mothers-with-epilepsy
#17
Arron S Lacey, William Owen Pickrell, Rhys H Thomas, Mike P Kerr, Cathy P White, Mark I Rees
OBJECTIVE: Small prospective studies have identified that children exposed to valproate in utero have poorer scores on cognitive testing. We wanted to identify whether children exposed to antiepileptic drugs (AEDs) in utero have poorer school performance. METHODS: We used anonymised, linked, routinely collected healthcare records to identify children born to mothers with epilepsy. We linked these children to their national attainment Key Stage 1 (KS1) tests in mathematics, language and science at the age of 7 and compared them with matched children born to mothers without epilepsy, and with the national KS1 results...
March 27, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29587185/pregnancy-outcomes-among-women-with-epilepsy-a-retrospective-cohort-study
#18
Atiwat Soontornpun, Tararak Choovanichvong, Theera Tongsong
OBJECTIVE: The objective of this study was to compare adverse pregnancy outcomes between pregnancies that involve epilepsy and those that do not and are identified as normal for the purposes of this paper. METHODS: A retrospective cohort study was carried out by accessing the maternal-fetal medicine (MFM) database to identify and review records of singleton pregnancies with epilepsy but with no other underlying disease (study group). A parallel group of low-risk pregnancies was randomly allocated as the control group...
March 24, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29584590/maternal-thyroid-function-in-early-pregnancy-and-child-neurodevelopmental-disorders-a-danish-nationwide-case-cohort-study
#19
Stine Linding Andersen, Stig Andersen, Peter Vestergaard, Jørn Olsen
BACKGROUND: Maternal thyroid dysfunction may adversely affect fetal brain development, but more evidence is needed to refine this hypothesis. The aim of this study was to evaluate potential fetal programming by abnormal maternal thyroid function on child neurodevelopmental disorders. METHODS: The design was a case-cohort study within the Danish National Birth Cohort (1997-2003). From the eligible cohort of 71,706 women, a random 12% sub-cohort (n = 7624) was selected, and all women (n = 2276) whose child was diagnosed with seizures, specific developmental disorder (SDD), autism spectrum disorder (ASD), and/or attention-deficit/hyperactivity disorder (ADHD) up to December 31, 2010, were identified...
April 2018: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29574624/mitochondrial-polg-related-disorder-presenting-prenatally-with-fetal-cerebellar-growth-arrest
#20
Michal Inbar-Feigenberg, Susan Blaser, Cynthia Hawkins, Patrick Shannon, Stacy Hewson, David Chitayat
We report the prenatal findings of severe cerebellar growth arrest in two siblings with POLG1 mutations. The first presented with seizures and lactic acidosis immediately after premature birth and was diagnosed with mitochondrial disease on muscle biopsy. Molecular DNA analysis confirmed homozygous missense mutation in the POLG1 gene. The pregnancy of the second sibling was monitored closely by repeat fetal ultrasounds since the parents declined invasive testing. A detailed fetal ultrasound at 19 weeks gestation showed a small cerebellum with transcerebellar diameter (TCD) on axial cranial imaging, measuring below the 5th centile for gestational age...
March 25, 2018: Metabolic Brain Disease
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