title: Early pregnancy cerebral venous thrombosis and status epilepticus treated with levetiracetam and lacosamide throughout pregnancy.
abstract: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke, accounting to less than 1% of all strokes. We describe a pregnant woman with a massive CVT in early pregnancy, complicated by status epilepticus. The mother was treated with levetiracetam, lacosamide, and enoxaparin throughout pregnancy. A male infant was born on pregnancy week 36, weighing 2.2kg. Both levetiracetam and and lacosamide were present in cord blood in levels similar to those in maternal blood. The infant was partially breast-fed and experienced poor feeding and sleepiness, starting to resolve after two first weeks. Milk samples were drawn 5 days after the delivery and a blood sample from the infant 3 days later. Lacosamide level in milk was low, resulting in an estimated relative infant dose of 1.8% of the maternal weight-adjusted daily dose in a fully breast-fed infant. This is the first case describing lacosamide use during pregnancy and lactation.
authors.affiliation: Institute of Clinical Medicine, Department of Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.
authors.forename: Pauli
authors.initials: P
authors.lastname: Ylikotila
authors.affiliation: Department of Forensic Medicine, Hjelt Institute, Faculty of Medicine, University of Helsinki, Finland.
authors.forename: Raimo A
authors.initials: RA
authors.lastname: Ketola
authors.affiliation: Institute of Clinical Medicine, Department of Gynaecology and Obstetrics, University of Turku, Turku, Finland.
authors.forename: Susanna
authors.initials: S
authors.lastname: Timonen
authors.affiliation: Teratology Information Service, HUSLAB and Helsinki University Central Hospital, Helsinki, Finland; Department of Clinical Pharmacology, Helsinki University, Helsinki, Finland.
authors.forename: Heli
authors.initials: H
authors.lastname: Malm
authors.affiliation: Institute of Clinical Medicine, Department of Neurology, University of Turku, Turku, Finland; Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland; Medbase Ltd., Turku, Finland. Electronic address: jori.ruuskanen@tyks.fi.
authors.forename: Jori O
authors.initials: JO
authors.lastname: Ruuskanen
mesh_terms: D000081:Acetamides / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D000328:Adult; D000927:Anticonvulsants / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D007231:Infant, Newborn; D000078334:Lacosamide; D000077287:Levetiracetam; D008297:Male; D008895:Milk, Human / Q000737:chemistry; D010889:Piracetam / Q000031:analogs & derivatives* / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D011247:Pregnancy; D013226:Status Epilepticus / Q000188:drug therapy*; D020246:Venous Thrombosis / Q000188:drug therapy*
chemical_list: D000081:Acetamides; D000927:Anticonvulsants; D000077287:Levetiracetam; D000078334:Lacosamide; D010889:Piracetam
keywords: Cerebral venous thrombosis; Lacosamide; Lactation; Pregnancy; Status epilepticus