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Epilepsy in pregnancy

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https://www.readbyqxmd.com/read/29754108/knowledge-of-women-issues-and-epilepsy-among-doctors-in-sudan
#1
Awab K Elnaeim, Mohamed K Elnaeim, Ismat B A Babiker
OBJECTIVE: The objective of this study was to assess the knowledge of doctors in Sudan about women issues related to epilepsy. METHODS: In this cross-sectional study that was conducted in Sudan during the period from October 2017 to December 2017, we used Google forms to collect data from 154 doctors using Knowledge of Women Issues and Epilepsy (KOWIE) II standardized questionnaire. RESULTS: Our studied group included house officers (n = 34), medical officers (n = 60), registrars (n = 52), and specialists (n = 8)...
May 10, 2018: Epilepsy & Behavior: E&B
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/29737274/antiepileptic-drug-monitoring-in-pregnancy-empire-a-double-blind-randomised-trial-on-effectiveness-and-acceptability-of-monitoring-strategies
#4
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/29730500/changes-in-antiepileptic-drug-prescribing-patterns-in-pregnant-women-with-epilepsy
#5
Kimford J Meador, Page B Pennell, Ryan C May, Elizabeth Gerard, Laura Kalayjian, Naymee Velez-Ruiz, Patricia Penovich, Jennifer Cavitt, Jaqueline French, Sean Hwang, Alison M Pack, Maria Sam, Eugene Moore, Dominic M Ippolito
OBJECTIVE: We analyzed current prescribing patterns for antiepileptic drugs (AEDs) in pregnant women with epilepsy (PWWE) at 20 USA tertiary epilepsy centers. METHODS: The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs (MONEAD) study is an NIH-funded, prospective, observational, multicenter investigation of pregnancy outcomes for both mother and child, which enrolled women from December 2012 to January 2016. Inclusion criteria for PWWE included ages 14-45 years and up to 20 weeks gestational age...
May 3, 2018: Epilepsy & Behavior: E&B
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/29719929/the-effect-of-parity-on-risk-of-complications-in-women-with-epilepsy-a-population-based-cohort-study
#7
Kim C Danielsson, Ingrid Borthen, Nils Erik Gilhus, Nils-Halvdan Morken
INTRODUCTION: Women with epilepsy have increased risk of complications in pregnancy with consequences for the mother and child. There are no studies on the influence of parity on complications in women with epilepsy. MATERIAL AND METHODS: This was a population-based cohort study of all first and second births in the Medical Birth Registry of Norway 1999-2013. Risks were estimated, and complication rates compared in distinct women with epilepsy treatment categories...
May 2, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29710218/fertility-and-birth-outcomes-in-women-with-epilepsy-seeking-pregnancy
#8
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
#9
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/29691249/hypertensive-pregnancy-complications-in-women-with-epilepsy-and-antiepileptic-drugs-a-population-based-cohort-study-of-first-pregnancies-in-norway
#10
Kim Christian Danielsson, Ingrid Borthen, Nils-Halvdan Morken, Nils Erik Gilhus
OBJECTIVES: To estimate the risk of hypertensive pregnancy complications in women with epilepsy, with and without antiepileptic drugs, and assess the risk associated with the four most common antiepileptic drugs. DESIGN: A population-based cohort study using linked data from the Medical Birth Registry of Norway and the Norwegian Prescription Database. Women with epilepsy with and without antiepileptic drugs were compared with women without epilepsy. SETTING: Norway, 2004-2012...
April 24, 2018: BMJ Open
https://www.readbyqxmd.com/read/29689338/the-ketogenic-diet-in-disease-and-development
#11
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/29686036/valproate-and-epilepsy-for-women-as-well-as-men
#12
Charlotte Lawthom
Sodium valproate remains the best drug for idiopathic generalised epilepsy. For men with the latter diagnosis, this is the drug of choice. Sodium valproate has an unacceptably high level of major fetal malformation and also causes learning disabilities in many children exposed to the drug in utero. Women of reproductive age should not normally be offered this drug. There are many women with refractory epilepsy who would benefit from this drug and who are not planning pregnancy. Individualised epilepsy care is the gold standard, not blanket bans on drug choice based on gender...
April 23, 2018: Practical Neurology
https://www.readbyqxmd.com/read/29680205/comparative-risk-of-major-congenital-malformations-with-eight-different-antiepileptic-drugs-a-prospective-cohort-study-of-the-eurap-registry
#13
Torbjörn Tomson, Dina Battino, Erminio Bonizzoni, John Craig, Dick Lindhout, Emilio Perucca, Anne Sabers, Sanjeev V Thomas, Frank Vajda
BACKGROUND: Evidence for the comparative teratogenic risk of antiepileptic drugs is insufficient, particularly in relation to the dosage used. Therefore, we aimed to compare the occurrence of major congenital malformations following prenatal exposure to the eight most commonly used antiepileptic drugs in monotherapy. METHODS: We did a longitudinal, prospective cohort study based on the EURAP international registry. We included data from pregnancies in women who were exposed to antiepileptic drug monotherapy at conception, prospectively identified from 42 countries contributing to EURAP...
April 18, 2018: Lancet Neurology
https://www.readbyqxmd.com/read/29677923/profiling-databases-to-facilitate-comparison-of-child-health-systems-across-europe-using-standardised-quality-markers
#14
Harshana Liyanage, Stacy Shinneman, Uy Hoang, Filipa Ferreira, Denise Alexander, Michael Rigby, Mitch Blair, Simon de Lusignan
Models of child primary health care vary across Europe. There are three categories, primary care paediatricians, general practitioner based, or mixed. This paper describes the metadata schema used in the profiling process of candidate data sources for appraisal for the Models of Child Health Appraised (MOCHA) project using the MOCHA International Research Opportunity Instrument (MIROI). The ten clinical indicators included: asthma, antibiotic stewardship, immunisation, rickets, diarrhea, epilepsy, depression, ADHD, enuresis and care of women during pregnancy...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29674237/eslicarbazepine-acetate-exposure-in-pregnant-women-with-epilepsy
#15
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/29667177/adverse-placental-effects-of-valproic-acid-studies-in-perfused-human-placentas
#16
Miriam Rubinchik-Stern, Miriam Shmuel, Jacob Bar, Michal Kovo, Sara Eyal
OBJECTIVE: In utero exposure to valproic acid (VPA) has been associated with worse pregnancy outcomes compared to all other antiepileptic drugs. We have previously shown that VPA alters the expression of placental transporters for hormones and nutrients in vitro and in pregnant mice. Here, our aim was to characterize the effects of short exposure to VPA on the expression of carriers for compounds essential for fetal development in human placentas ex vivo, under controlled conditions...
April 17, 2018: Epilepsia
https://www.readbyqxmd.com/read/29661925/changing-antiepilepsy-drug-prescribing-trends-in-women-with-epilepsy-in-the-uk-and-ireland-and-the-impact-on-major-congenital-malformations
#17
Michael O Kinney, James Morrow, Chris C Patterson, Ellen Campbell, Aline Russell, Henry W Smithson, Linda Parsons, Patrick J Morrison, Rebecca Bromley, Brenda Liggan, Norman Delanty, Beth Irwin, Stephen J Hunt, John J Craig
OBJECTIVES: After 20 years of data collection, pregnancy registers have informed prescribing practice. Various populations show trends for a reduction in valproate prescribing, which is associated with an increased risk of anatomical teratogenesis and neurodevelopmental effects in those exposed in utero. Our aim was to determine if any shifts in prescribing trends have occurred in the UK and Ireland Epilepsy and Pregnancy Register cohort and to assess if there had been any change in the overall major congenital malformation (MCM) rate over time...
April 16, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29661537/pyridoxine-dependent-epilepsy-is-late-onset-a-predictor-for-favorable-outcome
#18
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/29625554/antiepileptic-drug-exposure-in-pregnancy-and-pregnancy-outcome-from-national-drug-usage-data
#19
Noni Richards, David Reith, Michael Stitely, Alesha Smith
BACKGROUND: Antiepileptic drugs (AEDs) are used by pregnant women to manage conditions such as epilepsy and bipolar disorder even though they pose a risk to the developing foetus. This study aimed to determine the overall use of AEDs by women during their childbearing years and women who are pregnant and the association between AED use and rates of pregnancy termination and spontaneous abortion. METHODS: Retrospective population based cohort study using administrative databases in New Zealand between 2008 and 2014...
April 6, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29625362/epilepsy-related-concerns-among-patients-with-epilepsy-in-west-china
#20
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
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