Seizure control and treatment in pregnancy
Seizure control and treatment in pregnancy
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DOI：
10.1212/01.wnl.0000195888.51845.80
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发表时间：
2006-02
期刊：
影响因子：
9.9
通讯作者：
T. Tomson;D. Battino;E. Bonizzoni;J. Craig;D. Lindhout;E. Perucca;A. Sabers;F. Vajda;M. Brodie;B. Schmidt;F. Faravelli;R. Finnell;S. Messina;B. Moche;S. Ratti;A. Erba;D. Giavoni;L. Prato;S. Kochen;G. Luef;K. T. Berg;A. Marinis;D. Vitezić;J. Zarubova;R. Kuba;M. Dahl;R. Kälviäinen;M. Beaussart;L. Sturua;O. Toidze;B. Schmitz;P. Kwan;G. Barcs;Sanjeev V Thomas;M. Neufeld;D. Mamoli;M. Tanaka;R. Mameniškienė;G. Kiteva-Trencevska;K. Nakken;W. Liao;J. Jȩdrzejczak;A. Guekht;O. Lokshina;A. Russell;D. Sokić;V. Safcák;B. Čebular;M. Ferri;H. Baier;B. Tettenborn;C. Lai;Özkara;G. Escaray;C. Baumgartner;M. Feichtinger;M. Graf;M. Hamberger;M. Nagler;A. Hitchcock;J. Graham;R. Beran;S. Berkovic;A. Black;M. Cook;J. Dunne;N. Lawn;P. Silbert;C. Kilpatrick;T. O’Brien;C. Lander;D. McLaughlin;E. Somerville;P. Boon;K. Vonck;C. Asmad;D. Šepić-Grahovac;M. Brázdil;I. Novotná;I. Tyrlíková;H. Krijtová;I. Nemcova;D. Tislerova;H. Vacovska;J. Alving;V. Stubbings;J. Arentsen;J. Tørring;B. A. R. Hansen;G. Gulliksen;Birthe Pedersen;P. Sidenius;T. Sørensen;M. Worm;S. Rainesalo;R. Roivanen;A. Salmivaara;S. Kasradze;I. Coban;V. Gaus;R. Kretz;M. Bacher;B. Steinhoff;D. Dennig;N. Füratsch;B. Müffelmann;U. Specht;F. Wörmann;H. Hamer;F. Rosenow;A. Jung;A. Kumar;R. Roebling;Y. Weber;B. Kasper;F. Kerling;M. Lindenau;A. Schwenkhagen;S. Stodieck;H. Meencke;J. Pandian;U. Aguglia;C. Albano;G. Ambrosetto;F. Bisulli;L. Antonini;G. Maria;G. Battaglia;M. Curtis;R. Biondi;V. Sofia;G. Bogliun;M. Bondavalli;R. Campostrini;M. Casazza;S. Franceschetti;A. Citernesi;P. D'alessandro;E. Gallinella;G. D. Agazio;A. Neve;M. R. Feo;N. Foschi;A. Ortenzi;A. Paggi;A. Franza;C. Palmieri;K. Turner;C. Fumarola;C. Gregori;M. Vinci;C. A. Galimberti;R. Manni;R. Galli;R. Rocchi;A. Gambardella;A. Labate;A. Ganga;P. Garofalo;M. Panozzo;L. Guidolin;C. Labate;A. Papantonio;L. Specchio;A. Pistelli;M. Prugger;M. Vaccario;G. Zaccara;M. Zadra;M. Zucconi;K. Fukushima;M. Watanabe;M. Sasagawa;V. Jaskeviciene;E. Cvetkovska;A. Bader;C. V. Donselaar;D. Lambrechts;A. Oppen;D. Aurlien;G. Bråthen;E. Brodtkorb;B. Engelsen;T. Hauge;K. M. Lillestølen;R. Lossius;K. Oekseter;T. Svendsen;E. Taubøll;W. Telstad;L. Cabral-Lim;Y. Liu;E. Arthur;R. Duncan;J. Greene;I. Hamill;J. Leach;S. Yule;P. Parker;M. Ercegovac;N. Vojvodić;Gordana Toncev;S. Vujisić;N. Jovic;D. Vilanova;P. P. Mayor-P.;T. Escartin;M. Berdusán;J. Galan;M. Galiano;A. Gil-Nagel;M. Moro;E. Pastor;I. P. López-Fraile;B. Borre;L. Brattström;K. Gyllensköld;P. Flon;J. Hägglund;A. Wärme;I. Hämberg;H. Karlsson;E. Kumlien;B. Wiksten;A. Landtblom;B. Söderfeldt;U. Lindbom;H. Lindsten;A. Lundgren;K. Malmgren;G. Ekstedt;A. Nilsson;R. Palm;L. Sjöström;L. Stridh;S. Žemgulienė;B. Theander;J. Toft;A. Torstensson;L. Wallrup;T. Chang;D. Ataklı;H. Mısırlı;S. Velioğlu;N. Yeni
中科院分区：
文献类型：
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作者：
T. Tomson;D. Battino;E. Bonizzoni;J. Craig;D. Lindhout;E. Perucca;A. Sabers;F. Vajda;M. Brodie;B. Schmidt;F. Faravelli;R. Finnell;S. Messina;B. Moche;S. Ratti;A. Erba;D. Giavoni;L. Prato;S. Kochen;G. Luef;K. T. Berg;A. Marinis;D. Vitezić;J. Zarubova;R. Kuba;M. Dahl;R. Kälviäinen;M. Beaussart;L. Sturua;O. Toidze;B. Schmitz;P. Kwan;G. Barcs;Sanjeev V Thomas;M. Neufeld;D. Mamoli;M. Tanaka;R. Mameniškienė;G. Kiteva-Trencevska;K. Nakken;W. Liao;J. Jȩdrzejczak;A. Guekht;O. Lokshina;A. Russell;D. Sokić;V. Safcák;B. Čebular;M. Ferri;H. Baier;B. Tettenborn;C. Lai;Özkara;G. Escaray;C. Baumgartner;M. Feichtinger;M. Graf;M. Hamberger;M. Nagler;A. Hitchcock;J. Graham;R. Beran;S. Berkovic;A. Black;M. Cook;J. Dunne;N. Lawn;P. Silbert;C. Kilpatrick;T. O’Brien;C. Lander;D. McLaughlin;E. Somerville;P. Boon;K. Vonck;C. Asmad;D. Šepić-Grahovac;M. Brázdil;I. Novotná;I. Tyrlíková;H. Krijtová;I. Nemcova;D. Tislerova;H. Vacovska;J. Alving;V. Stubbings;J. Arentsen;J. Tørring;B. A. R. Hansen;G. Gulliksen;Birthe Pedersen;P. Sidenius;T. Sørensen;M. Worm;S. Rainesalo;R. Roivanen;A. Salmivaara;S. Kasradze;I. Coban;V. Gaus;R. Kretz;M. Bacher;B. Steinhoff;D. Dennig;N. Füratsch;B. Müffelmann;U. Specht;F. Wörmann;H. Hamer;F. Rosenow;A. Jung;A. Kumar;R. Roebling;Y. Weber;B. Kasper;F. Kerling;M. Lindenau;A. Schwenkhagen;S. Stodieck;H. Meencke;J. Pandian;U. Aguglia;C. Albano;G. Ambrosetto;F. Bisulli;L. Antonini;G. Maria;G. Battaglia;M. Curtis;R. Biondi;V. Sofia;G. Bogliun;M. Bondavalli;R. Campostrini;M. Casazza;S. Franceschetti;A. Citernesi;P. D'alessandro;E. Gallinella;G. D. Agazio;A. Neve;M. R. Feo;N. Foschi;A. Ortenzi;A. Paggi;A. Franza;C. Palmieri;K. Turner;C. Fumarola;C. Gregori;M. Vinci;C. A. Galimberti;R. Manni;R. Galli;R. Rocchi;A. Gambardella;A. Labate;A. Ganga;P. Garofalo;M. Panozzo;L. Guidolin;C. Labate;A. Papantonio;L. Specchio;A. Pistelli;M. Prugger;M. Vaccario;G. Zaccara;M. Zadra;M. Zucconi;K. Fukushima;M. Watanabe;M. Sasagawa;V. Jaskeviciene;E. Cvetkovska;A. Bader;C. V. Donselaar;D. Lambrechts;A. Oppen;D. Aurlien;G. Bråthen;E. Brodtkorb;B. Engelsen;T. Hauge;K. M. Lillestølen;R. Lossius;K. Oekseter;T. Svendsen;E. Taubøll;W. Telstad;L. Cabral-Lim;Y. Liu;E. Arthur;R. Duncan;J. Greene;I. Hamill;J. Leach;S. Yule;P. Parker;M. Ercegovac;N. Vojvodić;Gordana Toncev;S. Vujisić;N. Jovic;D. Vilanova;P. P. Mayor-P.;T. Escartin;M. Berdusán;J. Galan;M. Galiano;A. Gil-Nagel;M. Moro;E. Pastor;I. P. López-Fraile;B. Borre;L. Brattström;K. Gyllensköld;P. Flon;J. Hägglund;A. Wärme;I. Hämberg;H. Karlsson;E. Kumlien;B. Wiksten;A. Landtblom;B. Söderfeldt;U. Lindbom;H. Lindsten;A. Lundgren;K. Malmgren;G. Ekstedt;A. Nilsson;R. Palm;L. Sjöström;L. Stridh;S. Žemgulienė;B. Theander;J. Toft;A. Torstensson;L. Wallrup;T. Chang;D. Ataklı;H. Mısırlı;S. Velioğlu;N. Yeni
目的：分析孕妇癫痫发作的控制和治疗。方法：对参加 EURAP（国际抗癫痫药物 (AED) 和妊娠登记处）的 1,882 名癫痫女性的 1,956 次妊娠的癫痫控制和治疗情况进行前瞻性记录。结果：在所有病例中，58.3% 在整个怀孕期间没有癫痫发作。任何癫痫发作的发生均与定位相关性癫痫（OR：2.5；1.7至3.9）和多药治疗（OR：9.0；5.6至14.8）有关，对于强直阵挛性癫痫发作，与奥卡西平单药治疗（OR：5.4；1.6至17.1）有关。以妊娠早期为参考，63.6% 的癫痫发作控制在整个怀孕期间保持不变，其中 92.7% 在整个怀孕期间没有癫痫发作。对于癫痫发作频率发生变化的患者，17.3% 的患者癫痫发作频率增加，15.9% 的患者癫痫发作频率减少。 60 名孕妇（3.5%）在分娩期间发生癫痫发作，在怀孕期间癫痫发作的女性中更为常见（OR：4.8；2.3 至 10.0）。癫痫持续状态36例（抽搐12例），死产1例，无流产或孕产妇死亡病例。 62.7% 的妊娠中 AED 治疗保持不变。在妊娠癫痫发作（OR：3.6；2.8至4.7）和拉莫三嗪（OR：3.8；2.1至6.9）或奥卡西平（OR：3.7；1.1至12.9）单一疗法的妊娠中，AED的数量或剂量更常增加。结论：大多数癫痫患者在怀孕期间都能保持癫痫发作控制。接受奥卡西平治疗的女性癫痫发作风险明显较高，并且奥卡西平和拉莫三嗪组中药物负荷更频繁地增加，促使进一步研究与药代动力学变化的关系。与癫痫持续状态相关的风险似乎比之前报道的要低。
Objective: To analyze seizure control and treatment in pregnant women with epilepsy. Methods: Seizure control and treatment were recorded prospectively in 1,956 pregnancies of 1,882 women with epilepsy participating in EURAP, an international antiepileptic drugs (AEDs) and pregnancy registry. Results: Of all cases, 58.3% were seizure-free throughout pregnancy. Occurrence of any seizures was associated with localization-related epilepsy (OR: 2.5; 1.7 to 3.9) and polytherapy (OR: 9.0; 5.6 to 14.8) and for tonic-clonic seizures, with oxcarbazepine monotherapy (OR: 5.4; 1.6 to 17.1). Using first trimester as reference, seizure control remained unchanged throughout pregnancy in 63.6%, 92.7% of whom were seizure-free during the entire pregnancy. For those with a change in seizure frequency, 17.3% had an increase and 15.9% a decrease. Seizures occurred during delivery in 60 pregnancies (3.5%), more commonly in women with seizures during pregnancy (OR: 4.8; 2.3 to 10.0). There were 36 cases of status epilepticus (12 convulsive), which resulted in stillbirth in one case but no cases of miscarriage or maternal mortality. AED treatment remained unchanged in 62.7% of the pregnancies. The number or dosage of AEDs were more often increased in pregnancies with seizures (OR: 3.6; 2.8 to 4.7) and with monotherapy with lamotrigine (OR: 3.8; 2.1 to 6.9) or oxcarbazepine (OR: 3.7; 1.1 to 12.9). Conclusions: The majority of patients with epilepsy maintain seizure control during pregnancy. The apparently higher risk of seizures among women treated with oxcarbazepine and the more frequent increases in drug load in the oxcarbazepine and lamotrigine cohorts prompts further studies on relationships with pharmacokinetic changes. Risks associated with status epilepticus appear to be lower than previously reported.