This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
It is not yet established which antiepileptic drugs (AEDs) are most likely to allow an uncomplicated pregnancy and delivery of a baby who develops normally. Two recent studies of the risk of major malformations, a national birth registry1 and a prospective single experience,2 consisted mainly of carbamazepine (CBZ) or valproate (VPA) exposed pregnancies. Both suggested that first semester exposure to VPA monotherapy carried a higher risk of fetal malformation than exposure to CBZ monotherapy. There is an increased risk3 for abnormalities in infants exposed in utero to phenobarbital, a drug that not long ago was the recommended drug for pregnant women with epilepsy (WWE).
In this and a future issue of Neurology, three birth registries are reported. Cunnington et al.4 report results from the lamotrigine (LTG) registry and Wyszynski et al.5 report results from VPA-exposed pregnancies. Both reports track major birth defects evident by ultrasound or inspection within the first few days of life. Artama et al.6 report on the rate of malformations in offspring of WWE after exposure to several AEDs in monotherapy and polytherapy compared to offspring of untreated WWE.
Cunnington et al.4 report a 2.9% incidence of major defects in the infants of 414 WWE treated with LTG monotherapy. When LTG was used in polytherapy, there was a 12.5% incidence if it was used with VPA (88 exposures) and a 2.5% incidence with other AEDs (182 exposures). This multinational registry (12 years of observations) enrolled patients voluntarily by physician report, with postpartum physician information.
Wyszynski et al.5 report results …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
