4,713 results match your criteria Seizure Disorders in Pregnancy


Prediction Model for Vaginal Birth After Induction of Labor in Women With Hypertensive Disorders of Pregnancy.

Obstet Gynecol 2020 Jul 9. Epub 2020 Jul 9.

Department of Obstetrics and Gynecology, Women & Infants Hospital, Warren Alpert Medical School of Brown University, and the Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island.

Objective: To identify characteristics associated with vaginal delivery compared with cesarean delivery after labor induction among women with hypertensive disorders of pregnancy and to develop and validate a prediction model to assist in clinical care.

Methods: We studied a retrospective cohort of women with singleton pregnancies who had hypertensive disorders of pregnancy and who underwent induction of labor at 34 weeks of gestation or more from January 1, 2002, to March 31, 2013. Exclusion criteria included spontaneous labor, prelabor cesarean delivery, and known fetal anomalies. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003938DOI Listing

Evidence-based Anti-seizure Monotherapy in Newly Diagnosed Epilepsy: a New Approach.

Acta Neurol Scand 2020 Jul 6. Epub 2020 Jul 6.

Lund University, Faculty of Medicine, Department of Clinical Sciences Lund, Division of Clinical Sciences Helsingborg, Sweden.

Objectives: To describe the process and results of the updated Swedish practice guidelines for monotherapy in epilepsy.

Materials And Methods: The Swedish Medical Products Agency led the process together with medical experts. Evidence rating in accordance with the International League Against Epilepsy (ILAE) template was linked to the Cochrane group's Grade system. Read More

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http://dx.doi.org/10.1111/ane.13312DOI Listing

Maternal cigarette use during pregnancy and school readiness: An analysis of preschool age children in São Paulo, Brazil.

Early Hum Dev 2020 Jun 5;148:105103. Epub 2020 Jun 5.

Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, United States of America.

Background: Barriers to early childhood development (ECD) are a global concern. Limited research exists on prenatal smoking and ECD in vulnerable populations, especially as it relates to school readiness (SR).

Aims: To examine how maternal cigarette use during pregnancy is associated with SR in a sample of Brazilian preschool-age children. Read More

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http://dx.doi.org/10.1016/j.earlhumdev.2020.105103DOI Listing

Folic acid prescribed to prenatal and postpartum women who are also prescribed antiepileptic drugs in Japan: Data from a health administrative database.

Birth Defects Res 2020 Jul 2. Epub 2020 Jul 2.

Laboratory of Clinical Pharmacy, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Miyagi, Japan.

Background: The aim of this study was to evaluate the prevalence of folic acid (FA) prescription to prenatal and postpartum women who have also been prescribed antiepileptic drugs (AED) in Japan.

Methods: The data set used in this study included women covered by health insurance between 2005 and 2016. The prevalence of FA prescriptions between 180 days before pregnancy and 180 days postpartum was determined from a large administrative database, with the FA prescription classified according to dose and timing. Read More

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http://dx.doi.org/10.1002/bdr2.1748DOI Listing

Role of obstetricians in promoting pregnancy-related knowledge among women with epilepsy in Japan.

Epilepsy Behav 2020 Jun 26;111:107176. Epub 2020 Jun 26.

Department of Life Science and Bioethics, Graduate School of Medicine, Tokyo Medical and Dental University, Japan.

The importance of informing women with epilepsy (WWE) of pregnancy-related issues when they are of reproductive age is well recognized. However, in Japan, education on pregnancy-related issues for these patients is insufficient. Obstetricians encounter patients who have self-discontinued their medications upon realizing they are pregnant. Read More

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http://dx.doi.org/10.1016/j.yebeh.2020.107176DOI Listing

Prenatal Exposure to Antibiotics and Development of Epilepsy in Children.

J Clin Pharmacol 2020 Jun 23. Epub 2020 Jun 23.

Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

We aimed to confirm or reject previous reports on the association of prenatal antibiotic exposure and development of epilepsy in offspring by accounting for known and unidentified confounding factors. In a retrospective cohort investigation, we enrolled children aged 3-18 years born between 1998 and 2012 at a single regional hospital and their mothers. A computerized medication database was linked with hospital records. Read More

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http://dx.doi.org/10.1002/jcph.1674DOI Listing

Neurocysticercosis-related seizures in the post-partum period: two cases and a review of the literature.

Lancet Infect Dis 2020 Jun 19. Epub 2020 Jun 19.

Department of Infectious - Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Italy.

Neurocysticercosis, the infection of the CNS with larval cysts of Taenia solium, is a leading cause of seizures in low-income countries. The clinical presentation of neurocysticercosis is variable and depends on the number, size, and location of cysticerci, and on the immune response of the host. In most patients, the affected site is the brain parenchyma, where cysts can precipitate seizures. Read More

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http://dx.doi.org/10.1016/S1473-3099(20)30240-1DOI Listing

Is the Medicines and Healthcare products Regulator Agency (MHRA) guidance on sodium valproate acceptable to women of childbearing age?

J R Coll Physicians Edinb 2020 Jun;50(2):114-117

Department of Neurology, Ninewells Hospital and Medical School, Dundee, UK.

Background: The UK Medicines and Healthcare products Regulatory Agency (MHRA) published guidelines restricting the use of sodium valproate in women of childbearing age unless they consented to the pregnancy prevention programme (PPP), receiving counselling by an epilepsy specialist, or meeting exclusion criteria.

Methods: We contacted every woman of childbearing age on valproate for epilepsy in NHS Tayside (122).

Results: Seventeen out of 122 (13. Read More

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http://dx.doi.org/10.4997/JRCPE.2020.207DOI Listing

Congenital toxoplasmotic chorioretinitis following reinfection.

Eur J Obstet Gynecol Reprod Biol 2020 Aug 19;251:263-265. Epub 2020 Apr 19.

Department of General Surgery and Medical Surgical Specialities, University of Catania, Catania, Italy.

Toxoplasmosis does not usually give any symptoms to a pregnant woman and in most cases she does not realize to be infected. On the contrary, in the newborn, congenital toxoplasmosis can be responsible of hydrocephalus, microcephaly, intracranial calcifications, strabismus, blindness, epilepsy, mental retardation, thrombocytopenia, anemia and chorioretinitis. All these pathologies have been reported in the primary infection, while they are unusual in either reinfections or recurrences. Read More

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http://dx.doi.org/10.1016/j.ejogrb.2020.04.045DOI Listing

Association of Cerclage with Composite Adverse Outcomes among Women Delivered at 36 Weeks or Later.

Am J Perinatol 2020 Jun 10. Epub 2020 Jun 10.

Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas.

Objective:  This study aimed to compare the maternal and neonatal adverse outcomes among singletons delivered at 36 weeks or later with cerclage during index pregnancy versus those without cerclage.

Study Design:  This retrospective cohort study utilized the U.S. Read More

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http://dx.doi.org/10.1055/s-0040-1712962DOI Listing

New-onset epilepsy in women with first time seizures during pregnancy.

Seizure 2020 Jun 2;80:42-45. Epub 2020 Jun 2.

Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, 21287, United States.

Introduction: In women with epilepsy, seizure frequency and severity can be affected during pregnancy by factors such as changes in ASD (anti-seizure drug) metabolism, changes in hormone levels, and medication compliance. Some women with epilepsy experience seizure worsening during pregnancy, while others have an improvement. Most epileptic seizures during pregnancy occur in women with pre-existing epilepsy. Read More

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http://dx.doi.org/10.1016/j.seizure.2020.05.022DOI Listing

Risk of early neurodevelopmental outcomes associated with prenatal exposure to the antiepileptic drugs most commonly used during pregnancy: a French nationwide population-based cohort study.

BMJ Open 2020 Jun 7;10(6):e034829. Epub 2020 Jun 7.

Department of Epidemiology of Health Products, French National Agency for Medicines and Health Products Safety, Saint-Denis, France.

Objectives: To assess the association between prenatal exposure to monotherapy with the antiepileptic drugs (AEDs) most commonly used during pregnancy and the risk of various neurodevelopmental outcomes compared with lamotrigine.

Design: Nationwide population-based cohort study.

Setting: French national healthcare databases. Read More

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http://dx.doi.org/10.1136/bmjopen-2019-034829DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282331PMC

Antiepileptic Drugs Usage in Pregnant Women with Epilepsy in Saudi Arabia.

J Epilepsy Res 2019 Dec 31;9(2):134-138. Epub 2019 Dec 31.

King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.

Background And Purpose: Epilepsy is one of the most common neurological disorders requiring continuous treatment during pregnancy. In Saudi Arabia, there is only one publication that studied the outcome of pregnancies in women with epilepsy, published in 1999. The aim of the study is to determine the major congenital malformations in infants resulting from exposure to antiepileptic drugs in pregnant women with epilepsy. Read More

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http://dx.doi.org/10.14581/jer.19014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7251344PMC
December 2019

Prescribing for pregnancy: epilepsy.

Drug Ther Bull 2020 Jul 5;58(7):103-106. Epub 2020 Jun 5.

Obstetrics and Gynaecology, West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Trust, London, UK

Topics for DTB review articles are selected by DTB's editorial board to provide concise overviews of medicines and other treatments to help patients get the best care. Articles include a summary of key points and a brief overview for patients. Articles may also have a series of multiple choice CME questions. Read More

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http://dx.doi.org/10.1136/dtb.2019.000009DOI Listing

Knowledge of pregnancy and procreation in women with epilepsy of childbearing age: A 16-year comparative study in Poland.

Epilepsy Res 2020 Aug 22;164:106372. Epub 2020 May 22.

Epilepsy Diagnostic and Therapeutic Center, Foundation of Epileptology, Warsaw, Poland; Lazarski University, Warsaw, Poland. Electronic address:

Studies across countries and time periods have demonstrated insufficient pregnancy-related knowledge in women with epilepsy (WWE) of childbearing age. To assess the current state of such knowledge as well as the relevant time-related changes over 16 years in Poland, we conducted a study of WWE using a questionnaire developed in 2003. The participants were 656 WWE of childbearing age who completed online and paper-based questionnaires. Read More

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http://dx.doi.org/10.1016/j.eplepsyres.2020.106372DOI Listing

Clinical characteristics and fetal outcomes in women with epilepsy with planned and unplanned pregnancy: A retrospective study.

Seizure 2020 Jul 15;79:97-102. Epub 2020 May 15.

Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, China. Electronic address:

Purpose: To compare the antiepileptic drug (AED) treatment patterns, seizure control, and folic acid supplementation between planned and unplanned pregnancy in women with epilepsy (WWE) and to investigate the effects of planned pregnancy on fetal outcomes.

Methods: A prospectively collected database including WWE with pregnancy from Feb 2010 to Dec 2018 was retrospectively analyzed. Planned pregnancy was defined as WWE being regularly supervised by epileptologists from the time of intended pregnancy until delivery. Read More

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http://dx.doi.org/10.1016/j.seizure.2020.05.011DOI Listing

Effects of immunization with heat-killed Mycobacterium vaccae on autism spectrum disorder-like behavior and epileptogenesis in a rat model of comorbid autism and epilepsy.

Brain Behav Immun 2020 May 19. Epub 2020 May 19.

Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA; Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA. Electronic address:

Autism spectrum disorders (ASDs) and epilepsy are often comorbid. The basis for this co-occurrence remains unknown; however, inflammatory stressors during development are a shared risk factor. To explore this association, we tested the effect of repeated immunizations using a heat-killed preparation of the stress-protective immunoregulatory microbe Mycobacterium vaccae NCTC 11,659 (M. Read More

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http://dx.doi.org/10.1016/j.bbi.2020.05.034DOI Listing

Preconception Risk Factors for Autism Spectrum Disorder - A Pilot Study.

Brain Sci 2020 05 14;10(5). Epub 2020 May 14.

Department of Pediatric Neurology, Faculty of Medical Science in Katowice, Medical University of Silesia, 42-600 Katowice, Poland.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder of multifactorial etiology. Preconception risk factors are still poorly understood. A survey on preconception risk factors for ASD was conducted among parents of 121 ASD patients aged 3-12 years and parents of 100 healthy children aged 3-12 years. Read More

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http://dx.doi.org/10.3390/brainsci10050293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288185PMC

Pregnancy and Epilepsy: a Korean Tertiary Epilepsy Center Review.

J Korean Med Sci 2020 May 18;35(19):e119. Epub 2020 May 18.

Department of Neurology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.

Background: Pregnancy in women with epilepsy (WWE) is known to have a higher risk for fetal development complications, which may include congenital malformations. Unfortunately, information pertaining to pregnancy in WWE is difficult to obtain because there are considerable ethical issues preventing these studies from being conducted on pregnant women. Therefore, this study investigated the pregnancies of Korean WWE in a tertiary epilepsy center to observe data resulting from the outcome of the pregnancies. Read More

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http://dx.doi.org/10.3346/jkms.2020.35.e119DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234856PMC

A rat model of valproate teratogenicity from chronic oral treatment during pregnancy.

Epilepsia 2020 Jun 16;61(6):1291-1300. Epub 2020 May 16.

Department of Medicine (Royal Melbourne Hospital), Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia.

Objective: Sodium valproate (VPA), the most effective antiepileptic drug for patients with genetic generalized epilepsy (GGE), is a potent human teratogen that increases the risk of a range of congenital malformations, including spina bifida. The mechanisms underlying this teratogenicity are not known, but may involve genetic risk factors. This study aimed to develop an animal model of VPA-induced birth defects. Read More

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http://dx.doi.org/10.1111/epi.16536DOI Listing

Long-Term Effects of Intrauterine Exposure to Antidepressants on Physical, Neurodevelopmental, and Psychiatric Outcomes: A Systematic Review.

J Clin Psychiatry 2020 May 12;81(3). Epub 2020 May 12.

Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Objective: Reviews on child outcomes following in utero antidepressant exposure have focused on short-term outcomes. However, several recent individual studies reported on adverse physical, neurodevelopmental, and psychiatric outcomes beyond infancy and early childhood. The objective of this systematic review was to establish the long-term effects of prenatal antidepressant exposure on physical, neurodevelopmental, and psychiatric outcomes in individuals aged 4 years and older. Read More

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http://dx.doi.org/10.4088/JCP.19r12965DOI Listing

Principles of Epilepsy Management for Women in Their Reproductive Years.

Front Neurol 2020 28;11:322. Epub 2020 Apr 28.

Department of Neurology, Stony Brook Medicine, Stony Brook, NY, United States.

In the United States, there are over one million women with epilepsy (WWE) in their childbearing years. Pregnancy can be challenging for this population. A number of international registries have documented that children born to these women are at increased risk for major congenital malformations (MCM), lower intelligence quotient scores and neurodevelopmental disorders, when the mother is managed on antiseizure medications (ASMs). Read More

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http://dx.doi.org/10.3389/fneur.2020.00322DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7198776PMC

Shifting Valproic Acid to Levetiracetam in Women of Childbearing Age With Epilepsy: A Retrospective Investigation and Review of the Literature.

Front Neurol 2020 24;11:330. Epub 2020 Apr 24.

Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Taoyuan, Taiwan.

Valproic acid is the most high-risk teratogenic antiepileptic drug, and it may lead to fetal major congenital malformations. However, it is still used in women of childbearing age with epilepsy. The aim of this study was to report our experience of discontinuing or lowering valproic acid by adding levetiracetam, a low-risk teratogenic antiepileptic drug. Read More

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http://dx.doi.org/10.3389/fneur.2020.00330DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193743PMC

Histologic chorioamnionitis and risk of neurodevelopmental impairment at age 10 years among extremely preterm infants born less than 28 weeks of gestation.

Am J Obstet Gynecol 2020 May 6. Epub 2020 May 6.

Division of Pediatric Neurology, Department of Pediatrics, Boston University (Boston, MA).

Background: Children born extremely preterm whose placenta had histologic evidence of chorioamnionitis have early brain dysfunction, but little is known about neurological development at 10 years of age.

Objective: We investigated the association between histologic chorioamnionitis and neurodevelopmental impairment at 10 years among children born <28 weeks gestation (extremely preterm).

Methods: The multicenter Extremely Low Gestational Age Newborn (ELGAN) Study enrolled extremely preterm newborns from 2002-2004 at 14 U. Read More

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http://dx.doi.org/10.1016/j.ajog.2020.05.001DOI Listing

The impact and challenges of the 2018 MHRA statement on the use of sodium valproate in women of childbearing age during the first year of implementation, in a UK epilepsy centre.

Seizure 2020 Jul 17;79:8-13. Epub 2020 Apr 17.

Neurology Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK. Electronic address:

Purpose: On 24/04/2018, the United Kingdom (UK) Medicines and Healthcare Products Regulatory Agency (MHRA) clarified previous policies by issuing a statement, that the use of sodium valproate is contraindicated in women of childbearing potential unless the conditions of a pregnancy prevention programme are met, and only if other treatments are ineffective or not tolerated. We evaluated the impact of this over the first year of implementation in a tertiary epilepsy centre.

Methods: Cross-sectional study of all women under active follow up, or newly referred, of childbearing age (16-55 years), taking valproate for the treatment of epilepsy, over 12 months from 01/05/2018. Read More

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http://dx.doi.org/10.1016/j.seizure.2020.03.015DOI Listing

Valproate and folate: Congenital and developmental risks.

Epilepsy Behav 2020 Jul 3;108:107068. Epub 2020 May 3.

Department of Pathology and Laboratory Medicine, University of California Davis, USA.

Increasing awareness of the congenital and developmental risks associated with the use of sodium valproate (VPA) has led to recent European guidelines designed to avoid the use of this drug in pregnancy if effective alternative treatments are available. In the general population, it is well established that periconceptual folic acid reduces the risk of neural tube defects (NTDs) and possibly other congenital abnormalities. We here review the evidence 1) that VPA interferes with one-carbon metabolism, including the transport of methylfolate into the brain and the placenta by targeting folate receptors; 2) that VPA effects on the folate metabolic system contribute to congenital and developmental problems associated with VPA exposure; and 3) that genetic factors, notably polymorphisms related to one-carbon metabolism, contribute to the vulnerability to these VPA-induced risks. Read More

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http://dx.doi.org/10.1016/j.yebeh.2020.107068DOI Listing

Neonatal vitamin D status and risk of childhood epilepsy.

Epilepsia 2020 Jun 4;61(6):1282-1290. Epub 2020 May 4.

The Parker Institute, Research Unit for Dietary Studies, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.

Objective: Epilepsy is a nervous system abnormality that may be caused by unknown exposures during fetal development. Studies have shown neuroprotective effects of early exposure to vitamin D in other neurological disorders, and seasonal variation in birth of children with epilepsy. We aimed to investigate if neonatal 25(OH)D was associated with risk of childhood epilepsy. Read More

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http://dx.doi.org/10.1111/epi.16520DOI Listing

Gynecologic Management of Adolescents and Young Women With Seizure Disorders: ACOG Committee Opinion, Number 806.

Authors:

Obstet Gynecol 2020 May;135(5):e213-e220

Seizure disorders frequently are diagnosed and managed during adolescence; therefore, obstetrician-gynecologists who care for adolescents should be familiar with epilepsy and other seizure disorders, as well as antiepileptic drugs. Patients diagnosed with seizure disorders during childhood may have increased seizure activity with puberty and menarche due to the neuroactive properties of endogenous steroid hormones. Compared with patients without epilepsy, patients with epilepsy are more likely to experience anovulatory cycles, irregular menstrual bleeding, and amenorrhea. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003827DOI Listing

Gynecologic Management of Adolescents and Young Women With Seizure Disorders: ACOG Committee Opinion Summary, Number 806.

Authors:

Obstet Gynecol 2020 May;135(5):1242-1243

Seizure disorders frequently are diagnosed and managed during adolescence; therefore, obstetrician-gynecologists who care for adolescents should be familiar with epilepsy and other seizure disorders, as well as antiepileptic drugs. Patients diagnosed with seizure disorders during childhood may have increased seizure activity with puberty and menarche due to the neuroactive properties of endogenous steroid hormones. Compared with patients without epilepsy, patients with epilepsy are more likely to experience anovulatory cycles, irregular menstrual bleeding, and amenorrhea. Read More

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http://dx.doi.org/10.1097/AOG.0000000000003828DOI Listing

Intranasal diazepam (Valtoco) and midazolam (Nayzilam) for seizure clusters.

Authors:

Med Lett Drugs Ther 2020 Apr;62(1596):63-64

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Pregnancy after valproate withdrawal-Fetal malformations and seizure control.

Epilepsia 2020 May 21;61(5):944-950. Epub 2020 Apr 21.

Royal Brisbane and Women's Hospital and School of Medicine and Biomedical Science, University of Queensland, Brisbane, Queensland, Australia.

Objective: To assess the outcomes in women with epilepsy in relation to fetal malformation and epileptic seizure control during pregnancy when valproate (VPA) intake was ceased, or the drug's dose was reduced before pregnancy.

Methods: Statistical analysis of data collected in the Australian Pregnancy Register between 1999 and 2018 concerning 580 pregnancies previously treated with VPA, with the VPA dose reduced or the drug withdrawn prior to pregnancy in 158 cases.

Results: Although the available data have limitations, fetal malformation rates in the pregnancies studied were lower in the VPA changed pregnancies (4. Read More

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http://dx.doi.org/10.1111/epi.16505DOI Listing

Safety of in-utero antiretroviral exposure: neurologic outcomes in children who are HIV-exposed but uninfected.

AIDS 2020 Jul;34(9):1377-1387

Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.

Objective: To evaluate whether there is an increased risk of neurologic diagnoses in children who are HIV-exposed but uninfected (CHEU) exposed in utero to specific antiretroviral medications.

Design: Prospective cohort study of CHEU enrolled from 2007 to 2017.

Methods: We evaluated children for neurologic case status, including microcephaly, febrile seizures, seizure disorders, ophthalmologic disorders, and other neurologic disorders. Read More

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http://dx.doi.org/10.1097/QAD.0000000000002550DOI Listing

Risk factors for neonatal seizures: A case-control study in the province of Parma, Italy.

Epilepsy Behav 2020 Jun 15;107:107075. Epub 2020 Apr 15.

Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy. Electronic address:

Purpose: The present study evaluated the risk factors for electroencephalographic (EEG)-confirmed seizures during the whole neonatal period in preterm and term neonates born in the province of Parma between January 2009 and December 2014.

Methods: We selected as cases the infants that presented EEG-confirmed neonatal seizures (NS). Two population controls for each case were matched by gestational age (GA), sex, hospital, and period of birth. Read More

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http://dx.doi.org/10.1016/j.yebeh.2020.107075DOI Listing

Antiseizure drugs for women with epilepsy: Before, during, and after pregnancy.

Can Fam Physician 2020 Apr;66(4):266-269

Pharmacist and Associate Professor, University of Waterloo School of Pharmacy in Ontario.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145120PMC

A cohort study of the universal neonatal urine screening for congenital cytomegalovirus infection.

J Infect Chemother 2020 Aug 6;26(8):790-794. Epub 2020 Apr 6.

Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan.

Objectives: This prospective cohort study aimed to evaluate the efficacy of the universal neonatal urine screening, followed by diagnosis, workup and antiviral therapy for symptomatic congenital cytomegalovirus (CMV) infection to reduce neurological impairments and sequelae.

Methods: Neonates born in three facilities underwent the universal urine screening of PCR analyses for CMV-DNA. Neonates with symptomatic congenital CMV infection (cCMV) received oral valganciclovir (VGCV) of 32 mg/kg/day for six weeks or six months, and were evaluated for neurological outcomes including developmental quotient (DQ) and hearing function at around 18 months of corrected age. Read More

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http://dx.doi.org/10.1016/j.jiac.2020.03.009DOI Listing

A homozygote frameshift mutation in OCLN gene result in Pseudo-TORCH syndrome type I: A case report extending the phenotype with central diabetes insipidus and renal dysfunction.

Eur J Med Genet 2020 Jun 30;63(6):103923. Epub 2020 Mar 30.

Department of Medical Genetics, Cukurova University Faculty of Medicine, Adana, Turkey. Electronic address:

Intrauterine infections with the pathogens, including toxoplasmosis, other (syphilis, varicella, mumps, parvovirus, and HIV), rubella, cytomegalovirus, and herpes simplex (TORCH) in susceptible individuals during pregnancy, result in microcephaly, white matter disease, cerebral atrophy, and calcifications in the fetus. Pseudo-TORCH syndrome is an umbrella term, consisting of several syndromes, resultant from different genetic alterations and pathogenetic mechanisms. Band-like calcification with simplified gyration and polymicrogyria (BLC-PMG) is one of these conditions, resultant from biallelic mutations in the OCLN gene, located in the chromosome 5q13. Read More

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http://dx.doi.org/10.1016/j.ejmg.2020.103923DOI Listing

Expert opinion: use of valproate in girls and women of childbearing potential with epilepsy: recommendations and alternatives based on a review of the literature and clinical experience-a European perspective.

J Neurol 2020 Apr 1. Epub 2020 Apr 1.

Department of Neurology, Vivantes Humboldt-Klinikum Berlin, Berlin, Germany.

Valproate is a broad-spectrum antiepileptic drug (AED) of particular interest in pediatric epilepsy syndromes and idiopathic generalized epilepsy, as it is relatively more effective in these syndromes than other AEDs. In 2018, the European Medicines Agency introduced new restrictions on the use of valproate in girls and women of childbearing potential to avoid exposure during pregnancy. The strengthening of existing restrictions sparked controversy and debate among patients and the medical community. Read More

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http://dx.doi.org/10.1007/s00415-020-09809-0DOI Listing

Association of Preeclampsia in Term Births With Neurodevelopmental Disorders in Offspring.

JAMA Psychiatry 2020 Apr 1. Epub 2020 Apr 1.

Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, North Carolina.

Importance: Preeclampsia during pregnancy has been linked to an increased risk of cerebral palsy in offspring. Less is known about the role of preeclampsia in other neurodevelopmental disorders.

Objective: To determine the association between preeclampsia and a range of adverse neurodevelopmental outcomes in offspring after excluding preterm births. Read More

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http://dx.doi.org/10.1001/jamapsychiatry.2020.0306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113825PMC

Ischemic Stroke in Young Adults.

Authors:
Jukka Putaala

Continuum (Minneap Minn) 2020 Apr;26(2):386-414

Purpose Of Review: This article reviews current knowledge on epidemiology, risk factors and causes, diagnostic considerations, management, and prognosis of ischemic stroke in young adults (those 55 years old and younger).

Recent Findings: The incidence of ischemic stroke in young adults has been increasing since the 1980s, which has occurred in parallel with increasing prevalence of vascular risk factors and substance abuse among the younger population. Young adults have a considerably wider range of risk factors than older patients, including age-specific factors such as pregnancy/puerperium and oral contraceptive use. Read More

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http://dx.doi.org/10.1212/CON.0000000000000833DOI Listing

Neurodevelopmental Outcomes of Prenatal Preeclampsia Exposure.

Trends Neurosci 2020 Apr 6;43(4):253-268. Epub 2020 Mar 6.

Department of Psychiatry, University of Iowa Carver College of Medicine, Department of Psychiatry, Iowa City, IA, USA. Electronic address:

Preeclampsia is a dangerous hypertensive disorder of pregnancy with known links to negative child health outcomes. Here, we review epidemiological and basic neuroscience work from the past several decades linking prenatal preeclampsia to altered neurodevelopment. This work demonstrates increased rates of neuropsychiatric disorders [e. Read More

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http://dx.doi.org/10.1016/j.tins.2020.02.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7170230PMC

Inhibition of Valproic Acid-Induced Prenatal Developmental Abnormalities with Antioxidants in Rats.

ACS Omega 2020 Mar 2;5(10):4953-4961. Epub 2020 Mar 2.

Department of Pharmacy, IUB, Bahawalpur 63210, Pakistan.

Valproic acid (VP) is a very effective therapy for the management of generalized epilepsy. However, its use during pregnancy leads to increased risk of teratogenesis and cognitive malfunctioning in postnatal growing children. Antioxidants are used commercially as a palliative therapy. Read More

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http://dx.doi.org/10.1021/acsomega.9b03792DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7081441PMC

The ketogenic diet all grown up-Ketogenic diet therapies for adults.

Epilepsy Res 2020 May 10;162:106319. Epub 2020 Mar 10.

Comprehensive Epilepsy Center, Department of Neurology, Johns Hopkins University, Baltimore, MD, USA. Electronic address:

The use of ketogenic diet therapies (KDT) in adults has expanded in the last two decades and has been accompanied by a surge of new retrospective as well as prospective studies evaluating its efficacy in adults with epilepsy. In this review article, we will highlight the recent clinical trials and advances in the use of the ketogenic diet therapy (KDT) in adult patients with epilepsy. We will analyze the responder rate in regard to the epilepsy syndrome (focal vs generalized) to identify adults who are optimal to consider for KDT. Read More

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http://dx.doi.org/10.1016/j.eplepsyres.2020.106319DOI Listing

Neurological outcomes of congenital Zika syndrome in toddlers and preschoolers: a case series.

Lancet Child Adolesc Health 2020 May 18;4(5):378-387. Epub 2020 Mar 18.

Research Institute Professor Amorim Neto, Campina Grande, Brazil; Federal University of Campina Grande, Campina Grande, Brazil; UNIFACISA - University Center, Campina Grande, Brazil.

Background: Congenital Zika syndrome causes a spectrum of neurological symptoms with varying effects on function that require different therapeutic strategies. To date, this spectrum of effects and its clinical implications have not been completely described. We describe the neurological examination findings in toddlers and preschoolers, including predominant symptom complexes and comorbidities. Read More

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http://dx.doi.org/10.1016/S2352-4642(20)30041-9DOI Listing

Functional Language Network Connectivity in Children of Women with Epilepsy with Selective Antenatal Antiepileptic Drug Exposure.

Ann Indian Acad Neurol 2020 Mar-Apr;23(2):167-173. Epub 2020 Feb 26.

Department of Neurology, SCTIMST, Trivandrum, Kerala, India.

Purpose: Children of women with epilepsy and antenatal antiepileptic drug (AED) exposure have increased risk of language dysfunction. Our objective was to compare language related functional MRI network connectivity (FC) of children with women with epilepsy with antenatal AED exposure (CAED) with that of healthy children (COAED) for delineating functional basis of the language dysfunction.

Methods: CAED under prospective follow up in Kerala Registry of Epilepsy and Pregnancy were consecutively sampled. Read More

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http://dx.doi.org/10.4103/aian.AIAN_402_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061501PMC
February 2020

Well-being of mothers with epilepsy with school-aged children.

Epilepsy Behav 2020 Apr 6;105:106966. Epub 2020 Mar 6.

Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands; Research Institute of Child Development and Education, University of Amsterdam, the Netherlands. Electronic address:

Purpose: The purpose of the study was to examine different aspects of well-being in mothers with epilepsy with school-aged children.

Methods: In an observational study, mothers, identified from the European Registry of Antiepileptic Drugs and Pregnancy database in the Netherlands, completed questions on epilepsy, the impact of epilepsy on daily functioning, quality of life, behavioral problems, and parenting stress. Descriptive analyses were performed to examine the prevalence of behavioral problems and the impact of epilepsy on different aspects of the mother's daily functioning and family life. Read More

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http://dx.doi.org/10.1016/j.yebeh.2020.106966DOI Listing

Safety and Tolerability of Repetitive Transcranial Magnetic Stimulation During Pregnancy: A Case Report and Literature Review.

J Clin Neurophysiol 2020 Mar;37(2):164-169

Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.

Patients with neuropsychiatric disease may benefit from repetitive transcranial magnetic stimulation as a nonpharmacologic alternative to relieve symptoms of major depression, obsessive compulsive disorder, and perhaps other syndromes such as epilepsy. We present a case of repetitive transcranial magnetic stimulation treatment as an adjunct therapy for a patient experiencing refractory epileptic seizures during the third trimester of pregnancy. Notably, the patient tolerated repetitive transcranial magnetic stimulation well, without adverse events, and delivered a healthy child. Read More

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http://dx.doi.org/10.1097/WNP.0000000000000552DOI Listing

Interrupted time series analysis to assess changes in prescription filling around conception and implications for exposure misclassification.

Pharmacoepidemiol Drug Saf 2020 Jun 3;29(6):745-749. Epub 2020 Mar 3.

Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.

Purpose: Medication exposures in pregnancy are often defined by one or more prescription fills. Harmful effects could be underestimated if rapid discontinuation of use after pregnancy recognition is common. We used conception, a critical biological period, as an intervention in a novel application of interrupted time series analysis (ITSA). Read More

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http://dx.doi.org/10.1002/pds.4974DOI Listing

Neurocognition after prenatal levetiracetam, lamotrigine, carbamazepine or valproate exposure.

J Neurol 2020 Jun 28;267(6):1724-1736. Epub 2020 Feb 28.

Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands.

Objective: To examine neurocognitive functioning of children exposed prenatally to carbamazepine, lamotrigine, levetiracetam or valproate monotherapy.

Methods: In a prospective observational study, children aged 6 or 7 years, identified from the European Registry of Antiepileptic Drugs and Pregnancy database in The Netherlands, were assessed using the Wechsler Intelligence Scale for Children and the developmental neuropsychological assessment. Maternal IQ was measured using Wechsler Adult Intelligence Scale. Read More

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http://dx.doi.org/10.1007/s00415-020-09764-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293688PMC