Epilepsy, Pregnancy and Antiepileptic Drugs

フォーマット:

論文

責任表示:

Kaneko, Sunao

言語:

日本語

出版情報:

弘前大学医学部, 1986-09

著者名:

Kaneko, Sunao  

掲載情報:

弘前医学

ISSN:

0439-1721      

巻:

38

通号:

3

開始ページ:

434

終了ページ:

456

バージョン:

publisher

概要:

Clinical and basic researches on epilepsy and pregnancy. in particular of antiepilepticdrugs (AEDs) on the fetus and the epileptic mother, and those of pregnancy on the course ofepilepsy were reviewed.The complete control of seizures in the pregestational period and regular drug taking are veryimportant for better management of pregnant epileptics with medication, since the seizure frequencyremains mostly unchanged when the patient's compliance is good. If … the serum leveldecreases, one must confirm the patient's compliance. Once compliance has been established, thedose should be increased only when seizures occur.Most AEDs cross the placenta and some cause unwanted effects on the embryo, the fetus, orthe newborn.Thus pre-conceptional counselling should ensure that an epileptic embarks upon a pregnancywith her epilepsy well controlled by a minimal dose of AEDs, and adequate answers for the questionsraised by the patient should be given to prevent poor compliance.There is an increased risk of major congenital malformations among the offsprings of womenwith epilepsy, most of whom are on AEDs. Part of this increase is due to exposure to AEDs.Other factors also appear to play an important role. Prevention of malformation can take placebefore the onset of the pregnancy by decreasing the dose of the drug and/or changing from acombination of AEDs to a single drug, since there is a dose-response relation for teratogenesisand a greater occurrence of congenital malformation when the mother receives combined AEDtherapy.An aspect of prenatal growth deficiency that has raised concern is that brain growth may beaffected, producing microcephaly and mild to moderate mental retardation. However, the delayin the physical development of the offspring may be transient. The psychomotor retardationcontinued only through infancy. if they were nursed properly. 続きを見る

URL:

http://hdl.handle.net/10129/2040