Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child.

Background: Prenatal exposure to certain anti-seizure medications (ASMs) is associated with an increased risk of major congenital malformations (MCM). The majority of women with epilepsy continue taking ASMs throughout pregnancy and, therefore, information on the potential risks associated with ASM treatment is required.

Objectives: To assess the effects of prenatal exposure to ASMs on the prevalence of MCM in the child.

Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child.

Background: There is evidence that certain antiepileptic drugs (AEDs) are teratogenic and are associated with an increased risk of congenital malformation. The majority of women with epilepsy continue taking AEDs throughout pregnancy; therefore it is important that comprehensive information on the potential risks associated with AED treatment is available.

Objectives: To assess the effects of prenatal exposure to AEDs on the prevalence of congenital malformations in the child.

Imaging in neurocysticercosis.

Neurocysticercosis is a parasitic neurological infection caused by the ingestion of larvae from the adult tapeworm Taenia solium. We describe a man who presented with generalised tonic-clonic seizures. He had been previously diagnosed with epilepsy in Malawi, where he had emigrated from 2 years before this episode.

Treatment for epilepsy in pregnancy: neurodevelopmental outcomes in the child.

Background: Accumulating evidence suggests an association between prenatal exposure to antiepileptic drugs (AEDs) and increased risk of both physical anomalies and neurodevelopmental impairment. Neurodevelopmental impairment is characterised by either a specific deficit or a constellation of deficits across cognitive, motor and social skills and can be transient or continuous into adulthood. It is of paramount importance that these potential risks are identified, minimised and communicated clearly to women with epilepsy.

Acute stroke secondary to carotid artery dissection in a patient with germ cell tumour: did cisplatin play a role?

Background: Cisplatin-based chemotherapy - mainly the bleomycin, etoposide and cisplatin (BEP) regimen - has significantly improved the prognosis of testicular germ cell tumours (GCT). However, it has serious vascular side effects, including acute ischemic stroke.

Case Report: A 37-year-old man with no conventional cerebrovascular risk factors presented with right arm clumsiness followed by a transient episode of expressive dysphasia 3 h later.

The behavioral consequences of exposure to antiepileptic drugs in utero.

The aim of the study was to examine the behavior of 242 children, aged between 6 and 16 years, born to mothers with epilepsy. Exposure to sodium valproate (VPA) in utero was associated with high levels of parental stress induced by the child's maladaptive behavior. These children were also poorer for daily living skills and skills relating to socialization.

Therapeutic monitoring of antiepileptic drugs during pregnancy and in the postpartum period: is it useful?

As in all patient populations, epilepsy is common in pregnant women. Consequently, approximately 1 in 200 pregnancies is exposed to antiepileptic drugs (AEDs). Although exposure to AEDs in utero has been associated with an increased risk of major fetal malformations, most women with epilepsy require medication throughout pregnancy, since seizures themselves may be potentially harmful not only for the mother but also for the developing fetus.

Birth defects and epilepsy medication.

Epilepsy is one of the most common neurological problems in pregnancy. Approximately one in 200 pregnancies is to a woman with epilepsy taking antiepileptic drugs. For the majority of women, pregnancy proceeds without any apparent difficulties but there is growing evidence of an increased risk of major malformations and later cognitive problems in children exposed to antiepileptic drugs in utero.

Dysmorphic features: an important clue to the diagnosis and severity of fetal anticonvulsant syndromes.

Background: In utero exposure to antiepileptic drugs (AEDs) can result in several different teratogenic effects including major malformations, dysmorphic facial features, and learning and behavioural problems. It is estimated that there is a 2-3-fold increase in the risk of malformations compared with the general population. The risk of cognitive impairment and behavioural problems is less clear.

Neuropsychological effects of exposure to anticonvulsant medication in utero.

Objective: To investigate the long-term differential drug effects on cognitive functioning in school-aged children exposed to antiepileptic drugs (AEDs) in utero.

Methods: Mothers with epilepsy were recruited from specialist epilepsy clinics and obstetric clinics from the Liverpool and Manchester region. The mothers and their children were recruited without prior knowledge of their AED treatment during pregnancy or the health of the offspring.

The longer term outcome of children born to mothers with epilepsy.

Objectives: To determine the prevalence of cognitive delay and possible associated dysmorphic features in children exposed to antiepileptic drugs (AEDs) in utero.

Design: Retrospective study of children born to mothers with epilepsy.

Setting: Regional epilepsy clinics in Liverpool and Manchester, UK.

Common antiepileptic drugs in pregnancy in women with epilepsy.

Background: The potential adverse effects of antiepileptic drug (AED) exposure in pregnancy have been well recognised but the relative risks of specific antiepileptic drug exposures remain poorly understood.

Objectives: To assess the adverse effects of commonly used antiepileptic drugs on maternal and fetal outcomes in pregnancy in women with epilepsy. Comparison of outcomes following specific antiepileptic drug exposures in utero to unexposed pregnancies in the general population or women with epilepsy are described.

Additional educational needs in children born to mothers with epilepsy.

Objectives: To examine the relative risks of additional educational needs (AENs) in children exposed to antiepileptic drug (AED) monotherapy and polytherapy regimes in utero.

Methods: A retrospective survey of women between the ages of 16 to 40 registered at the Mersey Regional Epilepsy Clinic, who received a postal questionnaire concerning their experience of pregnancy and the subsequent schooling of live-born children.

Results: 721 (57%) women of the 1267 approached returned an adequately completed questionnaire; 330 (46%) had given birth to at least one live-born child.

Hepatic sarcoidosis complicated by hepatocellular carcinoma.

A case of a 63-year-old man with a long-standing history of portal hypertension secondary to hepatic sarcoidosis who developed hepatocellular carcinoma is reported.