Neurodevelopmental effects of antiepileptic drugs.
Although the vast majority of children born to women with epilepsy are normal, these children are at increased risk for both anatomic and cognitive impairments. Current evidence suggests that the defects are the result of in utero antiepileptic drug (AED) exposure combined with a genetic predispositon. However, the exact mechanisms underlying these effects remain to be delineated. AED polytherapy increases the risk, but it remains uncertain if specific AEDs pose an overall greater threat. Most women with epilepsy cannot avoid AEDs during pregnancy because of the greater risks posed by seizures to the mother and fetus. Therefore, current recommendations emphasize definitive diagnosis and the use of AED monotherapy at the lowest effective dose if treatment is indicated. Prenatal folate and multivitamins should also be given routinely to women of childbearing age who require AED therapy.
Meador
Kimford J
KJ
Department of Neurology, Medical College of Georgia, 1120 15th Street (BA3410), Augusta, GA 30912, USA. kmeador@neuro.mcg.edu
D000014:Abnormalities, Drug-Induced / Q000209:etiology*; D000818:Animals; D000927:Anticonvulsants / Q000009:adverse effects* / Q000494:pharmacology; D001921:Brain / Q000187:drug effects* / Q000254:growth & development; D004827:Epilepsy / Q000188:drug therapy; D004852:Epoxy Compounds / Q000378:metabolism; D005260:Female; D005492:Folic Acid / Q000378:metabolism; D005609:Free Radicals / Q000378:metabolism; D006801:Humans; D007511:Ischemia / Q000503:physiopathology; D001523:Mental Disorders / Q000139:chemically induced* / Q000209:etiology; D016202:N-Methylaspartate / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D013723:Teratogens
D000927:Anticonvulsants; D004852:Epoxy Compounds; D005609:Free Radicals; D013723:Teratogens; D016202:N-Methylaspartate; D005492:Folic Acid