Identifying areas for improvement in epilepsy management in developing countries: an experience of neurocooperation in Cameroon

Delgado-Suárez, Celia; García‐Azorín, David; Monje, Mariana H.G.; Molina-Sanchez, Maria; Gómez‐Iglesias, Patricia; Kurtis, Mónica; García‐Morales, Irene

doi:10.1016/j.nrleng.2019.02.010

Cited by 1 publication

(1 citation statement)

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“…Over 90% of women with epilepsy deliver healthy children. Pregnancy in women with epilepsy, as already mentioned, should be planned and the woman should prepare for the pregnancy in a conscious manner [8]. The risk of congenital malformations in children of mothers with epilepsy depends on the type of administered drug, the number of drugs, and the dosage-it is higher than in the general population and reaches 3% in those using carbamazepine (CBZ) or lamotrigine (LTG); 7% for valproate (VPA); 15% in those receiving two or more AEDs [9].…”

Section: Preconception Care In Women With Epilepsymentioning

confidence: 99%

Epilepsy in Pregnancy—Management Principles and Focus on Valproate

Błaszczyk¹,

Miziak

Pluta

et al. 2022

IJMS

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An estimated 60 million people worldwide suffer from epilepsy, half of whom are women. About one-third of women with epilepsy are of childbearing age. The childbirth rate in women with epilepsy is about 20–40% lower compared to that of the general population, which may be partly due to a lower number of these women being in relationships. Lower fertility in women with epilepsy may be linked to the disease itself, but it is mainly a result of the treatment provided. Valproate, as an antiepileptic drug inhibiting histone deacetylases, may affect the expression of genes associated with cell cycle control and cellular differentiation. Evidently, this drug is associated with the risk of malformations although other antiepileptic drugs (AEDs) may also trigger birth defects, however, to a lower degree. Valproate (and to a certain degree other AEDs) may induce autism spectrum disorders and attention deficit hyperactivity disorder. The main mechanism responsible for all negative effects of prenatal exposure to valproate seems inhibition of histone deacetylases. Animal studies show a reduction in the expression of genes involved in social behavior and an increase in hippocampal cytokines. Valproate-induced oxidative stress may also contribute to neural tube defects. Interestingly, paternal exposure to this AED in mice may trigger neurodevelopmental disorders as well although a population-based cohort study does not confirm this effect. To lower the risk of congenital malformations and neurodevelopmental disorders, a single AED at the optimal dose and supplementation with folic acid is recommended. VPA should be avoided in women of childbearing age and especially during pregnancy.

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Section: Preconception Care In Women With Epilepsymentioning

confidence: 99%