Abstract
A 38-year-old woman has posttraumatic medically refractory epilepsy in the past 2 years. Her epilepsy monitoring is consistent with multifocal seizure foci. She is on a combination of oxcarbazepine, lamotrigine, topiramate, and vagal nerve stimulator and continues to experience at least one episode of convulsive seizure per week. She had got married a year before her head injury and is considering pregnancy. Would you recommend against pregnancy in this case?
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References
Tomson T, Landmark CJ, Battino D. Antiepileptic drug treatment in pregnancy: changes in drug disposition and their clinical implications. Epilepsia. 2013;54(3):405.
Kwan P, Sperling MR. Refractory seizures. Try additional antiepileptic drugs (after two have failed) or go directly to early surgery evaluation? Epilepsia. 2009;50 Suppl 8:57–62.
Vajda FJE, O’Brien TJ, Lander CM, Graham J, Eadie MJ. The efficacy of the newer antiepileptic drugs in controlling seizures in pregnancy. Epilepsia. 2014;55(8):1229–34.
Vajda FJE, O’Brien TJ, Graham J, Lander CM, Eadie MJ. Associations between particular types of fetal malformation and antiepileptic drug exposure in utero. Acta Neurol Scand. 2013;128:228–34.
Palac S, Meador KJ. Antiepileptic drugs and neurodevelopment: an update. Curr Neurol Neurosci Rep. 2011;11:423–7.
Meadow SR. Anticonvulsant drugs and congenital abnormalities. Lancet. 1968;2:1296.
Meador K, Reynolds MW, Crean S, Fahrbach K, Probst C. Pregnancy outcomes in women with epilepsy: a systematic review and meta-analysis of published pregnancy registries and cohorts. Epilepsy Res. 2008;81:1–13.
Shorvon SD, Tomson T, Cock HR. The management of epilepsy during pregnancy—progress is painfully slow. Epilepsia. 2009;50:973–4.
Alsaad AM, Chaudhry SA, Koren G. First trimester exposure to topiramate and the risk of oral clefts in the offspring: a systematic review and meta-analysis. Reprod Toxicol. 2015;53:45–50.
Hernandez-Diaz S, Smith CR, Shen A, Mittendorf R, Hauser WA, Yerby M, et al. Comparative safety of antiepileptic drugs during pregnancy. Neurology. 2012;78:1692–9.
Husain MM, Stegman D, Trevino K. Pregnancy and delivery while receiving vagus nerve stimulation for the treatment of major depression: a case report. Ann Gen Psychiatry. 2005;4:16.
Salerno G, Passamonti C, Cecchi A, Zamponi N. Vagus nerve stimulation during pregnancy: an instructive case. Childs Nerv Syst. 2015 Sep 9. [Epub ahead of print].
Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Sabers A, et al. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry. Lancet Neurol. 2011;10:609–17.
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Sazgar, M., Vajda, F.J.E., Harden, C.L. (2016). Ever Advise Against Pregnancy?. In: Sazgar, M., Harden, C. (eds) Controversies in Caring for Women with Epilepsy. Springer, Cham. https://doi.org/10.1007/978-3-319-29170-3_12
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DOI: https://doi.org/10.1007/978-3-319-29170-3_12
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