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Antiepileptics in pregnancy

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https://www.readbyqxmd.com/read/29285947/eslicarbazepine-acetate-in-epilepsies-with-focal-and-secondary-generalised-seizures-systematic-review-of-current-evidence
#1
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
https://www.readbyqxmd.com/read/29279889/association-of-folic-acid-supplementation-during-pregnancy-with-the-risk-of-autistic-traits-in-children-exposed-to-antiepileptic-drugs-in-utero
#2
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
https://www.readbyqxmd.com/read/29238228/prenatal-exposure-to-antipsychotic-medication-and-use-of-primary-health-care-system-in-childhood-a-population-based-cohort-study-in-denmark
#3
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
https://www.readbyqxmd.com/read/29227268/characteristics-of-west-syndrome-in-georgia-preliminary-results-of-the-prospective-study
#4
A Kvernadze, N Tatishvili, T Kipiani, G Lomidze
West syndrome hasn't been thoroughly investigated in Georgia. The purposes of our study were a) to assess the clinical and etiological peculiarities of West syndrome, based on MRI data and its relation to the long-term outcome; b) to assess the evolution of West syndrome and its relation to patient characteristics; c) to compare the efficacies of treatments with ACTH and antiepileptic drugs (AEDs); d) to evaluate the neuropsychological outcome after 12 and 24 months and their early predictors. We evaluated 31 patients (17 male, 14 female) with infantile spasms...
November 2017: Georgian Medical News
https://www.readbyqxmd.com/read/29223932/pregnancy-related-knowledge-of-women-with-epilepsy-an-internet-based-survey-in-german-speaking-countries
#5
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...
December 7, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29223574/evaluation-of-the-effects-of-antiepileptic-drugs-on-folic-acid-uptake-by-human-placental-choriocarcinoma-cells
#6
Yuko Kurosawa, Ayako Furugen, Ayako Nishimura, Katsuya Narumi, Masaki Kobayashi, Ken Iseki
Folate status during pregnancy is important for fetal development and health. The placenta plays an important role in supplying the fetus with folate. Most women with epilepsy continue their medication during pregnancy. In the present study, we aimed to evaluate the effects of 16 antiepileptic drugs, clinically used for treatment of epilepsy, on folic acid uptake in two in vitro placental models, BeWo and JEG-3 cells. Short-term exposure to antiepileptic drugs had no effects on [3H]-folic acid uptake by BeWo cells...
December 6, 2017: Toxicology in Vitro: An International Journal Published in Association with BIBRA
https://www.readbyqxmd.com/read/29179105/predicting-epileptic-seizure-control-during-pregnancy
#7
Frank J E Vajda, T J O'Brien, J E Graham, A A Hitchcock, C M Lander, M J Eadie
OBJECTIVE: The objective of the study was to assess whether the type of seizure disorder present in the prospective mother with epilepsy, her use of antiepileptic drugs (AEDs) in early pregnancy, and her seizure control before pregnancy help predict her prospects for seizure freedom throughout pregnancy. METHODS: This paper is based on data accumulated in the Australian Pregnancy Register (APR) between 1998 and late 2016. Information was analyzed concerning epileptic seizure occurrence and AED therapy taken before and during pregnancy, using simple statistical and confidence interval (C...
January 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29141532/seizures-and-antiepileptic-drugs-from-pathophysiology-to-clinical-practice
#8
Nihan CarCaka, Cigdem Ozkara
Recurrent, spontaneous seizure activity caused by abnormal neuronal firing in the brain is a hallmark of epilepsy, a common chronic neurological disorder. Recent research that has expanded the knowledge of the cellular and molecular mechanisms that modulate neuronal excitability and network activity in the brain provides the development and discovery of antiepileptic drugs (AEDs). AED therapy starts with the selection of the most appropriate drug for individual patient on the basis of strategic decision of the risk-benefit ratio...
November 14, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29128586/contraception-pregnancy-and-peripartum-experiences-among-women-with-epilepsy-in-bhutan
#9
Sheliza Halani, Lhab Tshering, Esther Bui, Sarah J Clark, Sara J Grundy, Tandin Pem, Sonam Lhamo, Ugyen Dema, Damber K Nirola, Chencho Dorji, Farrah J Mateen
INTRODUCTION: Reports on the reproductive health of women with epilepsy (WWE) in low- and middle-income countries (LMICs) are limited. Bhutan is a lower income country with a high estimated prevalence of epilepsy and no out-of-pocket payment requirements for health visits or medications. METHODS: We developed a 10-category survey to interview WWE ages 20-59 years in the Kingdom of Bhutan to understand their contraceptive use and peripartum experiences. WWE were recruited from 2016-2017 from an existing epilepsy cohort and their reproductive health data were merged with epilepsy and socioeconomic data obtained from initial clinical evaluations performed between 2014 and 2016...
December 2017: Epilepsy Research
https://www.readbyqxmd.com/read/29116720/the-croatian-model-of-integrative-prospective-management-of-epilepsy-and-pregnancy
#10
Snježana Miškov, Romana Gjergja Juraški, Ivan Mikula, Silvio Bašić, Marija Bošnjak Pašić, Vesna Košec, Zlatko Sabol, Aleksandra Fučić, Tomislav Sajko, Vanja Bašić Kes
Epilepsy is the most common neurological complication in pregnancy. Women with epilepsy have a higher risk of complications in pregnancy. In Croatia, women with epilepsy are treated by neurologists at tertiary centers according to the place of residence. We prospectively followed-up pregnancies in women with epilepsy and healthy controls, and analyzed the factors responsible for their delivery outcomes and development of their babies. Healthy pregnant women had a higher level of education and economic status, but pregnant women with epilepsy took folic acid in a higher proportion than controls, possibly due to timely preconception counseling...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29114815/maternal-use-of-antiepileptic-agents-during-pregnancy-and-major-congenital-malformations-in-children
#11
Rebecca L Bromley, Jennifer Weston, Anthony G Marson
Clinical Question: Is maternal use of antiepileptic drugs during pregnancy associated with major congenital malformations in children? Bottom Line: Certain antiepileptic drugs were associated with increased rates of congenital malformations (eg, spina bifida, cardiac anomalies). Lamotrigine (2.31% in 4195 pregnancies) and levetiracetam (1.77% in 817 pregnancies) were associated with the lowest risk and valproate was associated with the highest risk (10.93% in 2565 pregnancies) compared with the offspring of women without epilepsy (2...
November 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29076416/novel-treatment-and-new-drugs-in-epilepsy-treatment
#12
Elissavet Eskioglou, M P Perrenoud, Phiilippe Ryvlin, Jan Novy
We now get benefit from more than 20 antiepileptic drugs (AEDs) in the care of people with epilepsy. Newer generation of AED is associated with a more favourable tolerability profile than older generation AEDs which makes them easier to use, despite similar efficacy. In order to define the place of newer generation AEDs in the therapy, we review here the main current guidelines about their use for a special issue concerning antiepileptic drugs in neurosurgical practice. We also discuss how to tailor the treatment with newer generation AEDs according to the patient's needs and comorbid conditions...
October 24, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29073690/fetal-valproate-syndrome-still-a-problem-today
#13
Katharina Wiedemann, Tanja Stüber, Monika Rehn, Eric Frieauff
Introduction Fetal exposition to valproate can lead to a cluster of facial dysmorphism, congenital anomalies and neurodevelopmental retardation. Case Report In this report we describe 2 cases of fetal valproate syndrome. In the first case, the gravida had a valproate medication before and during pregnancy with additional folic acid. She delivered a male premature infant at 25+2 weeks of gestation due to preterm labor and rupture of the membranes. Physical examination showed even in the premature infant typical signs of fetal valproate syndrome with trigonocephaly, epicanthal folds, broad root of the nose, low-set ears, thin upper lip and anteverted nares...
October 2017: Zeitschrift Für Geburtshilfe und Neonatologie
https://www.readbyqxmd.com/read/29064543/effect-of-valproic-acid-administration-during-pregnancy-on-postnatal-development-of-cerebellar-cortex-and-the-possible-protective-role-of-folic-acid
#14
Saber I Shona, Ayman A Rizk, Abir O El Sadik, Hossam Y Emam, Eid N Ali
BACKGROUND: Valproic acid (VPA), one of the most important antiepileptic drugs (AEDs), is proved to be inevitable for epileptic pregnant women to limit the hazards of convulsions on the fetuses and mothers. Periconceptional folic acid supplementation was investigated to protect against several birth defects. However, its role against VPA cerebellar toxicity was not properly investigated. AIM: The present study was conducted to evaluate the protective effect of folic acid against VPA cerebellar neurotoxicity...
October 24, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29054513/maternal-and-fetal-outcomes-associated-with-vagus-nerve-stimulation-during-pregnancy
#15
Anne Sabers, Dina Battino, Erminio Bonizzoni, John Craig, Dick Lindhout, Emilio Perucca, Sanjeev V Thomas, Torbjörn Tomson, Frank Vajda
OBJECTIVE: To access the effect of vagus nerve stimulation (VNS) on the outcome of pregnancy. METHODS: We used the International Registry of Antiepileptic Drugs and Pregnancy (EURAP) and its network to search for women receiving adjunctive VNS during pregnancy. Data on maternal and fetal outcomes were extracted from the registry databases and outcomes were evaluated. RESULTS: Twenty-six pregnancies were identified in 25 women. All women were exposed to a relative high VNS stimulation level (mean duty cycle 18%, range 5%-51%)...
November 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28931341/the-neurotoxic-effects-of-prenatal-gabapentin-and-oxcarbazepine-exposure-on-newborn-rats
#16
Zuleyha Erisgin, Bulent Ayas, Jens R Nyengaard, N Ercument Beyhun, Yuksel Terzi
AIM: Teratogenicity is a problematic issue for pregnant women because of X-ray radiation, drugs, and genetic and unknown variables. First-generation antiepileptic drugs (AED) like valproic acid are well-known teratogens for developing fetuses. However, their usage is necessary in order to prevent maternal seizures. The underlying mechanism of birth defects associated with AED exposure remains unclear and information about the neurotoxic effects of prenatal exposure to AED is still limited...
October 5, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28857118/anti-epileptic-drug-exposure-and-risk-of-foetal-death-in-utero
#17
F J E Vajda, T J O'Brien, J Graham, A A Hitchcock, C M Lander, M J Eadie
OBJECTIVE: To clarify whether anti-epileptic drug exposure during pregnancy is associated with an increased risk of intrauterine foetal death. METHODS: Analysis of data from 2064 pregnancies with known outcomes included in the Australian Register of Antiepileptic Drugs in Pregnancy, 170 of the pregnancies being unexposed to the drugs in at least the first half of pregnancy. RESULTS: The relative risk (6.46; 95% C.I. 0.90, 46.22) of intrauterine death appeared higher, though not statistically significantly higher, in drug-exposed pregnancies compared with unexposed ones (3...
August 31, 2017: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/28856694/fetal-growth-and-premature-delivery-in-pregnant-women-on-antiepileptic-drugs
#18
Sonia Hernández-Díaz, Thomas F McElrath, Page B Pennell, W Allen Hauser, Mark Yerby, Lewis B Holmes
OBJECTIVE: To evaluate the effects of epilepsy and antiepileptic drugs (AEDs) used during pregnancy on fetal growth and preterm delivery. METHODS: This study included singleton liveborn infants born to women enrolled in the North American Antiepileptic Drug Pregnancy Registry between 1997 and 2016. Data were collected prospectively through telephone interviews. The prevalence of preterm birth (<37 weeks) and small for gestational age status (SGA) among infants exposed prenatally to AEDs when used by women with epilepsy (WWE) or women without epilepsy (WWOE) was compared with that among infants unexposed to AEDs and born to WWOE...
September 2017: Annals of Neurology
https://www.readbyqxmd.com/read/28814092/flow-cytometric-examination-of-apoptotic-effect-on-brain-tissue-in-postnatal-period-created-by-intrauterine-oxcarbazepine-and-gabapentin-exposure
#19
Z Erisgin, Y Tekelioglu
OBJECTIVE: For epileptics, pregnancy contains the balance between no seizure period and antiepileptic use having the least teratogenicity risk. The purpose is to analyse with flow cytometry the apoptotic effects on postnatal brain tissue caused by prenatal use of second generation antiepileptics oxcarbazepine (OXC) and gabapentin (GBP) having different effect mechanisms. METHOD: 30 (n = 5 each group) Wistar albino male rats (45-days-old) are used. First 3 groups are exposed to OXC (100 mg/kg/day), GBP (50 mg/kg/day), and saline, respectively on the 1st-5th prenatal days (preimplantation-implantation period) while the second 3 groups are exposed to the same substances on the 6th-15th prenatal days (organogenesis), respectively...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/28762701/epilepsy-treatment-options
#20
REVIEW
Gerald Liu, Nicole Slater, Allen Perkins
The occurrence of a single seizure does not always require initiation of antiepileptic drugs. Risk of recurrent seizures should guide their use. In adults, key risk factors for recurrence are two unprovoked seizures occurring more than 24 hours apart, epileptiform abnormalities on electroencephalography, abnormal brain imaging, nocturnal seizures, or an epileptic syndrome associated with seizures. In children, key risk factors are abnormal electroencephalography results, an epileptic syndrome associated with seizures, severe head trauma, and cerebral palsy...
July 15, 2017: American Family Physician
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