The teratogenic risk of antiepileptic drug polytherapy.

Abstract:

PURPOSE:To compare the risks of fetal malformation during pregnancy associated with antiepileptic drug (AED) polytherapy and monotherapy. METHODS:Statistical analysis of malformation rate and antiepileptic drug exposure data from the Australian Register of Antiepileptic Drugs in Pregnancy, and from the literature. RESULTS:The calculated relative risk (RR) value for AED polytherapy compared with monotherapy was below 1.0 in only 3 of 14 literature publications. In the register, at 1 year postnatally there were fetal malformations in 5.32% of 282 AED polytherapy pregnancies, and in 7.84% of 791 AED monotherapy pregnancies, an RR of 0.68 [95% confidence interval (CI) 0.39-1.17). For pregnancies exposed to valproate, the RR of fetal malformation (0.39, 95% CI 0.20-0.89) was lower in polytherapy (7.26%) than in monotherapy (17.9%); the difference did not depend on valproate dosage. The RR values for fetal malformation were not significantly different for AED polytherapy and monotherapy when valproate was not involved. Logistic regression suggested that coadministration of lamotrigine may have reduced the malformation risk from valproate. DISCUSSION:The fetal hazard of AED polytherapy relative to monotherapy may depend more on the degree of exposure to valproate than on the fact of polytherapy per se. Coadministration with lamotrigine may lower the fetal risk of valproate therapy.

journal_name

Epilepsia

journal_title

Epilepsia

authors

Vajda FJ,Hitchcock AA,Graham J,O'Brien TJ,Lander CM,Eadie MJ

doi

10.1111/j.1528-1167.2009.02336.x

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

805-10

issue

5

eissn

0013-9580

issn

1528-1167

pii

EPI2336

journal_volume

51

pub_type

杂志文章,评审
  • Adverse effects of valproate on bone: defining a model to investigate the pathophysiology.

    abstract:PURPOSE:Bone disease and fractures are common with chronic antiepileptic drug (AED) therapy, but the underlying mechanisms are poorly understood. This study aimed to characterize adverse bone effects of valproate and to identify mouse strains either resistant or sensitive to these effects. METHODS:Seven mouse strains ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2009.02516.x

    authors: Senn SM,Kantor S,Poulton IJ,Morris MJ,Sims NA,O'Brien TJ,Wark JD

    更新日期:2010-06-01 00:00:00

  • Pathophysiological mechanisms of focal cortical dysplasia: a critical review of human tissue studies and animal models.

    abstract::Cortical dysplasia (CD, also known as malformations of cortical development) are the pathological substrates in a large percentage of patients with pharmacoresistant epilepsy who may be amenable to surgical treatment. Therefore, research on the mechanisms of dysplastic lesion formation and epileptogenicity is of param...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1528-1167.2007.01064.x

    authors: Najm IM,Tilelli CQ,Oghlakian R

    更新日期:2007-01-01 00:00:00

  • Some facts about sleep relevant for Landau-Kleffner syndrome.

    abstract::Our understanding of the neural mechanisms of non-rapid eye movement sleep (NREM) is steadily increasing. Given the intriguing activation of paroxysmal activity during NREM sleep in patients with Landau-Kleffner syndrome (LKS), a thorough characterization of commonalities and differences between the neural correlates ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2009.02218.x

    authors: Mascetti L,Foret A,Bonjean M,Matarazzo L,Dang-Vu T,Maquet P

    更新日期:2009-08-01 00:00:00

  • Adenosine kinase and adenosine receptors A1 R and A2A R in temporal lobe epilepsy and hippocampal sclerosis and association with risk factors for SUDEP.

    abstract:OBJECTIVE:The "adenosine hypothesis of SUDEP" (sudden unexpected death in epilepsy) predicts that a seizure-induced adenosine surge combined with impaired metabolic clearance can foster lethal apnea or cardiac arrest. Changes in adenosine receptor density and adenosine kinase (ADK) occur in surgical epilepsy patients. ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.16487

    authors: Patodia S,Paradiso B,Garcia M,Ellis M,Diehl B,Thom M,Devinsky O

    更新日期:2020-04-01 00:00:00

  • The assessment and treatment of concerns and anxiety in patients undergoing presurgical monitoring for epilepsy.

    abstract:PURPOSE:This study investigated the impact of a treatment information package on patients being monitored for possible surgical treatment for temporal lobe epilepsy. METHODS:One hundred patients were randomly assigned to either a high- or low-information preparation condition. Levels of anxiety were tested soon after ...

    journal_title:Epilepsia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1111/j.1528-1157.1999.tb02037.x

    authors: Andrewes D,Camp K,Kilpatrick C,Cook M

    更新日期:1999-11-01 00:00:00

  • Ipsilateral and contralateral MRI volumetric abnormalities in chronic unilateral temporal lobe epilepsy and their clinical correlates.

    abstract:PURPOSE:To assess the presence, extent, and clinical correlates of quantitative MR volumetric abnormalities in ipsilateral and contralateral hippocampus, and temporal and extratemporal lobe regions in unilateral temporal lobe epilepsy (TLE). METHODS:In total, 34 subjects with unilateral left (n = 15) or right (n = 19)...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.0013-9580.2005.27004.x

    authors: Seidenberg M,Kelly KG,Parrish J,Geary E,Dow C,Rutecki P,Hermann B

    更新日期:2005-03-01 00:00:00

  • A comparison of two methods for estimating the health care costs of epilepsy.

    abstract:PURPOSE:Previous studies have estimated medical care costs of epilepsy by applying unit costs to estimated utilization or by summing costs for (a) ambulatory care and hospitalizations coded as epilepsy and (b) procedures and drugs specifically associated with the diagnosis or treatment of epilepsy. These methods may un...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.2000.tb00288.x

    authors: Frost FJ,Hurley JS,Petersen HV,Gunter MJ,Gause D

    更新日期:2000-08-01 00:00:00

  • Severe burns as a consequence of seizures in patients with epilepsy.

    abstract::We report 10 seizure-related thermal injuries severe enough to require hospitalization in patients with epilepsy. Eight of the ten incidents were with patients who had had seizures with impaired consciousness two or more times a month. This suggests that seizure frequency is a risk factor and implies the importance of...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1992.tb02290.x

    authors: Spitz MC

    更新日期:1992-01-01 00:00:00

  • Phenytoin penetration into brain after administration of phenytoin or fosphenytoin.

    abstract:PURPOSE:This study was designed to measure the brain penetration of phenytoin (PHT) after intravenous (i.v.) administration of either standard PHT or fosphenytoin (FPHT), a PHT prodrug. The study was formulated to answer the question whether the time required for FPHT to be converted to PHT in the bloodstream would del...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1999.tb02068.x

    authors: Walton NY,Uthman BM,El Yafi K,Kim JM,Treiman DM

    更新日期:1999-02-01 00:00:00

  • Vagus nerve stimulation elevates seizure threshold in the kindling model.

    abstract:PURPOSE:  Vagus nerve stimulation (VNS) provides partial relief of medically refractory partial seizures in a subset of patients. The optimal pattern of stimulation and the mechanism of the antiseizure effects are uncertain. Establishing the efficacy of VNS in an animal model of epilepsy would provide an experimental p...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2012.03646.x

    authors: Alexander GM,McNamara JO

    更新日期:2012-11-01 00:00:00

  • Anticonvulsant efficacy of topiramate in phenytoin-resistant kindled rats.

    abstract:PURPOSE:We evaluated the anticonvulsant efficacy of topiramate (TPM), a structurally novel antiepileptic drug (AED), in amygdala kindled rats that had been preselected with respect to their response to phenytoin (PHT). METHODS:Anticonvulsant response was tested by determining the afterdischarge threshold (ADT; i.e., a...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.2000.tb00176.x

    authors: Reissmüller E,Ebert U,Löscher W

    更新日期:2000-04-01 00:00:00

  • The burden of decisional uncertainty in the treatment of status epilepticus.

    abstract:OBJECTIVE:Treatments for convulsive status epilepticus (SE) have a wide range of effectiveness. The estimated effectiveness of non-intravenous benzodiazepines (non-IV BZDs) ranges from approximately 70% to 90% and the estimated effectiveness of non-benzodiazepine antiseizure medications (non-BZD ASMs) ranges from appro...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.16646

    authors: Sánchez Fernández I,Gaínza-Lein M,Barcia Aguilar C,Amengual-Gual M,Loddenkemper T

    更新日期:2020-10-01 00:00:00

  • Incidence of epilepsy and unprovoked seizures in Rochester, Minnesota: 1935-1984.

    abstract::The incidence of epilepsy and of all unprovoked seizures was determined for residents of Rochester, Minnesota U.S.A. from 1935 through 1984. Age-adjusted incidence of epilepsy was 44 per 100,000 person-years. Incidence in males was significantly higher than in females and was high in the first year of life but highest...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1993.tb02586.x

    authors: Hauser WA,Annegers JF,Kurland LT

    更新日期:1993-05-01 00:00:00

  • Long-term effects of continual intake of phenobarbital on the spontaneously epileptic rat.

    abstract::Spontaneously epileptic rats (SER) are a double mutant (zi/zi, tm/tm) spontaneously exhibiting both tonic and absence-like seizures. We examined the long-term effects of continual intake of phenobarbital (PB) on SER as a method of assessing long-term evaluation of antiepileptic drugs (AEDs). Food pellets containing 0....

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1990.tb05353.x

    authors: Serikawa T,Kogishi K,Yamada J,Ohno Y,Ujihara H,Fujita Y,Sasa M,Takaori S

    更新日期:1990-01-01 00:00:00

  • Excitatory action of GABA on immature neurons is not due to absence of ketone bodies metabolites or other energy substrates.

    abstract::Brain slices incubated with glucose have provided most of our knowledge on cellular, synaptic, and network driven mechanisms. It has been recently suggested that γ-aminobutyric acid (GABA) excites neonatal neurons in conventional glucose-perfused slices but not when ketone bodies metabolites, pyruvate, and/or lactate ...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/j.1528-1167.2011.03132.x

    authors: Ben-Ari Y,Tyzio R,Nehlig A

    更新日期:2011-09-01 00:00:00

  • Stereotactic MRI-guided laser interstitial thermal therapy for extratemporal lobe epilepsy.

    abstract:OBJECTIVE:Magnetic resonance imaging (MRI)-guided laser interstitial thermal therapy (MRg-LITT) is an alternative to open epilepsy surgery. We assess safety and effectiveness of MRg-LITT for extratemporal lobe epilepsy (ETLE) in patients who are considered less favorable for open resection. METHODS:We retrospectively ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.16614

    authors: Gupta K,Cabaniss B,Kheder A,Gedela S,Koch P,Hewitt KC,Alwaki A,Rich C,Ramesha S,Hu R,Drane DL,Gross RE,Willie JT

    更新日期:2020-08-01 00:00:00

  • Human glioma cells induce hyperexcitability in cortical networks.

    abstract:PURPOSE:Patients with gliomas frequently present with seizures, but the factors associated with seizure development are still poorly understood. In this study, we assessed peritumoral synaptic network activity in a glioma animal model and tested the contribution of aberrant glutamate release from gliomas on glioma-asso...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2012.03557.x

    authors: Campbell SL,Buckingham SC,Sontheimer H

    更新日期:2012-08-01 00:00:00

  • Cortical epileptogenesis--Hughlings Jackson and his predecessors.

    abstract:AIM:To trace the concept that the cerebral cortex is the site of epileptogenesis before Hughlings Jackson published the idea in 1870 in the paper "A study of convulsions" which marks the beginning of modern epileptology. METHOD:Perusal of 19th century English language medical literature. RESULT:The existence of corti...

    journal_title:Epilepsia

    pub_type: 传,历史文章,杂志文章

    doi:10.1111/j.1528-1167.2007.01163.x

    authors: Eadie MJ

    更新日期:2007-11-01 00:00:00

  • Transient global amnesia as a postictal state from recurrent partial seizures.

    abstract::A 60-year-old patient had a 3-year history of recurrent memory disturbances. The video electroencephalographic (EEG) recording of one attack showed that the amnesic state, which clinically resembled transient global amnesia, was characterized by a normal EEG tracing followed by electroclinical complex partial seizures...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1991.tb05545.x

    authors: Tassinari CA,Ciarmatori C,Alesi C,Cardinaletti L,Salvi F,Rubboli G,Plasmati R,Forti A,Michelucci R

    更新日期:1991-11-01 00:00:00

  • An evaluation of the impact of health worker and patient education on the care and compliance of patients with epilepsy in Zimbabwe.

    abstract:PURPOSE:The use of primary health care personnel to identify cases of epilepsy and initiate simple treatment protocols has been advocated as a solution to the numeric inadequacy and uneven distribution of medical manpower available for the management of epilepsy in developing countries. This study sought to evaluate th...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1999.tb00749.x

    authors: Adamolekun B,Mielke JK,Ball DE

    更新日期:1999-04-01 00:00:00

  • Muscarinic receptor loss and preservation of presynaptic cholinergic terminals in hippocampal sclerosis.

    abstract:PURPOSE:Prior single-photon emission tomography studies showed losses of muscarinic acetylcholine receptor (MAChR) binding in patients with refractory mesial temporal lobe epilepsy. Experimental animal studies demonstrated transient losses of MAChR due to electrically induced seizures originating in the amygdala. Howev...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1999.tb01986.x

    authors: Pennell PB,Burdette DE,Ross DA,Henry TR,Albin RL,Sackellares JC,Frey KA

    更新日期:1999-01-01 00:00:00

  • Comparative pharmacokinetic study of chewable and conventional carbamazepine in children.

    abstract::Fifteen children (7 boys and 8 girls) with generalized tonic-clonic seizures (GTCS) and partial seizures with elementary or complex symptomatology, treated with carbamazepine (CBZ) alone (n = 7) or in combination with either phenobarbital (PB, n = 6) or clobazam (CLB, n = 2) given for at least 3 months at stable indiv...

    journal_title:Epilepsia

    pub_type: 临床试验,杂志文章

    doi:10.1111/j.1528-1157.1993.tb02390.x

    authors: Cornaggia C,Gianetti S,Battino D,Granata T,Romeo A,Viani F,Limido G

    更新日期:1993-01-01 00:00:00

  • Is the cell death in mesial temporal sclerosis apoptotic?

    abstract:PURPOSE:Mesial temporal sclerosis (MTS) is characterized by neuronal loss in the hippocampus. Studies on experimental models and patients with intractable epilepsy suggest that apoptosis may be involved in neuronal death induced by recurrent seizures. METHODS:We searched evidence for apoptotic cell death in temporal l...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1046/j.1528-1157.2003.37402.x

    authors: Uysal H,Cevik IU,Soylemezoglu F,Elibol B,Ozdemir YG,Evrenkaya T,Saygi S,Dalkara T

    更新日期:2003-06-01 00:00:00

  • Differences between patients with temporal lobe seizures and those with other forms of epileptic attacks.

    abstract::Seventy-eight patients with temporal lobe type seizures were precisely matched for age, sex, and Wechsler I.Q. levels with patients suffering from other seizure types. Statistically significant differences were established between the groups in regard to treatment response, etiologies, and behavioral variables. Furthe...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1157.1976.tb03409.x

    authors: Rodin EA,Katz M,Lennox K

    更新日期:1976-09-01 00:00:00

  • The development of intellectual abilities in pediatric temporal lobe epilepsy.

    abstract:PURPOSE:The aim of this study was to examine the impact of clinical variables, particularly age at onset of epilepsy, on intellectual function in a group of children with temporal lobe epilepsy (TLE). METHODS:We reviewed the preoperative neuropsychological test results of 79 children with unilateral TLE who subsequent...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2006.00904.x

    authors: Cormack F,Cross JH,Isaacs E,Harkness W,Wright I,Vargha-Khadem F,Baldeweg T

    更新日期:2007-01-01 00:00:00

  • The progression of electrophysiologic abnormalities during epileptogenesis after experimental traumatic brain injury.

    abstract:OBJECTIVE:Posttraumatic epilepsy (PTE) accounts for 20% of acquired epilepsies. Experimental models are important for studying epileptogenesis. We previously reported that repetitive high-frequency oscillations with spikes (rHFOSs) occur early after lateral fluid percussion injury (FPI) and may be a biomarker for PTE. ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.13486

    authors: Reid AY,Bragin A,Giza CC,Staba RJ,Engel J Jr

    更新日期:2016-10-01 00:00:00

  • Defining epileptogenic networks: Contribution of SEEG and signal analysis.

    abstract::Epileptogenic networks are defined by the brain regions involved in the production and propagation of epileptic activities. In this review we describe the historical, methodologic, and conceptual bases of this model in the analysis of electrophysiologic intracerebral recordings. In the context of epilepsy surgery, the...

    journal_title:Epilepsia

    pub_type: 杂志文章,评审

    doi:10.1111/epi.13791

    authors: Bartolomei F,Lagarde S,Wendling F,McGonigal A,Jirsa V,Guye M,Bénar C

    更新日期:2017-07-01 00:00:00

  • Lateralizing value of the auditory aura in partial seizures.

    abstract:PURPOSE:To describe the semiological features of auditory aura and to assess their possible lateralizing value in partial epilepsy. METHODS:Out of a series of 8,000 patients with epilepsy, we investigated 121 cases with partial seizures in whom auditory features were the first ictal symptom. According to the dominant ...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/j.1528-1167.2006.00881.x

    authors: Florindo I,Bisulli F,Pittau F,Naldi I,Striano P,Striano S,Michelucci R,Testoni S,Baruzzi A,Tinuper P

    更新日期:2006-01-01 00:00:00

  • Efficacy of the classic ketogenic and the modified Atkins diets in refractory childhood epilepsy.

    abstract:OBJECTIVE:We aimed to compare the efficacy, safety, and tolerability of a modified Atkins diet (MAD) with the classic ketogenic diet (KD) for the treatment of intractable childhood epilepsy. METHODS:From March 2011 to March 2014, 104 patients aged 1-18 years who had refractory epilepsy were randomly assigned to each d...

    journal_title:Epilepsia

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/epi.13256

    authors: Kim JA,Yoon JR,Lee EJ,Lee JS,Kim JT,Kim HD,Kang HC

    更新日期:2016-01-01 00:00:00

  • Does adherence to epilepsy quality measures correlate with reduced epilepsy-related adverse hospitalizations? A retrospective experience.

    abstract::In 2011, the American Academy of Neurology (AAN) established eight epilepsy quality measures (EQMs) for chronic epilepsy treatment to address deficits in quality of care. This study assesses the relationship between adherence to these EQMs and epilepsy-related adverse hospitalizations (ERAHs). A retrospective chart re...

    journal_title:Epilepsia

    pub_type: 杂志文章

    doi:10.1111/epi.12965

    authors: Ladner TR,Morgan CD,Pomerantz DJ,Kennedy VE,Azar N,Haas K,Lagrange A,Gallagher M,Singh P,Abou-Khalil BW,Arain AM

    更新日期:2015-05-01 00:00:00