Halo 194 (Jan 2018)
Treatment of epilepsy during pregnancy and neurodevelopmental damage in children
Abstract
Introduction Numerous studies show the relationship between prenatal exposure to antiepileptics and an increased risk of neurodevelopmental damage. Neurodevelopmental damage is characterized either by a specific deficit or combination of defects of the cognitive, motor and social nature, and can be transient or chronic. The aim of this paper is to draw attention to the potential risk of neurodevelopmental damage and congenital malformation in children of mothers who have been on anti-epileptics during the gestation period through a case report from practice. Case report A boy aged 7 years was hospitalized at the neurology department due to frequent headache without a propagation that began 7 days before admission. The boy is on valproat therapy since 2013. The hydrocephalus was operated after the ICH 2010, when the VP shunt was placed at the Department of Neurosurgery UDK Tirsov. From the personal anamnesis concerned, the first child from the third neatly controlled pregnancy. Mother is from age 11 to AET. The last epi attack was in 2013. Currently on Levotiracetam therapy. During the first pregnancy, on phenobarbital therapy, pregnancy was terminated by a consiliatory decision due to Dendy-Woker sy, 2006. During the second pregnancy Lamotrigine and Phenobarbitone, pregnancy ended with a spontaneous abortion in 8 GN. During the III pregnancy on Lamotrigine therapy. The third pregnancy due to placental overdose was completed by emergency caesarean section in 31 GN. Psychomotor development slowed down. He passed for 16 months, spoke with 2.5 years. In 2013, he had an attack of febrile convulsions since he was on AET valproate. Conclusion: Based on previous developments, lamotrigine (LTG) and levetiracetam (LEV) have the lowest risk, while phenobarbital carries an extremely high risk. Most women with epilepsy should continue with their medication during pregnancy, as uncontrolled attacks also have a risk of mothers.
