John Libbey Eurotext

Management of epilepsy in pregnancy: a report from the International League Against Epilepsy Task Force on Women and Pregnancy Volume 21, numéro 6, December 2019

Auteurs
1 Department of Clinical Neuroscience Karolinska Institutet, and Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
2 Epilepsy Center, Department of Neurophysiology and Experimental Epileptology, Fondazione IRCCS Istituto Neurologico CARLO BESTA, Milan, Italy
3 Division of Evolution and Genomic Science, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; Royal Manchester Children's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
4 Epilepsy Center, ENyS, CONICET, Hosp. El Cruce, Hosp. R. Mejía, Univ Buenos Aires, Argentina
5 Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, CA, USA
6 Department of Neurology, Harvard Medical School, Divisions of Epilepsy and Women's Health, Brigham and Women's Hospital, Boston, MA, USA
7 Department of Neurology, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, Kerala State, India
* Correspondence: Torbjörn Tomson Department of Clinical Neuroscience, Karolinska Institutet, Department of Neurology, Karolinska University Hospital, SE 171 76 Stockholm, Sweden
  • Mots-clés : epilepsy, pregnancy, antiepileptic drugs, foetal risks, teratogenesis
  • DOI : 10.1684/epd.2019.1105
  • Page(s) : 497-517
  • Année de parution : 2019

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The risks associated with use of antiepileptic drugs during pregnancy are a major concern for all women with epilepsy with childbearing potential. These risks have to be balanced against foetal and maternal risks associated with uncontrolled seizures. This report from the International League Against Epilepsy Task Force on Women and Pregnancy aims to provide a summary of relevant data on these risks as a basis for expert opinion recommendations for the management of epilepsy in pregnancy. The report reviews data on maternal and foetal risks associated with seizures as well as teratogenic risks associated with antiepileptic drug exposure, including effects on intrauterine growth, major congenital malformations, and developmental and behavioural outcomes. The impact of pregnancy on seizure control and on the pharmacokinetics of antiepileptic drugs are also discussed. This information is used to discuss how treatment may be optimized before conception and further managed during pregnancy.