Differences in treatment of epilepsy in pregnancy: A worldwide survey.

Journal

Neurology. Clinical practice
ISSN: 2163-0402
Titre abrégé: Neurol Clin Pract
Pays: United States
ID NLM: 101577149

Informations de publication

Date de publication:
Jun 2019
Historique:
received: 25 09 2018
accepted: 17 01 2019
entrez: 26 7 2019
pubmed: 26 7 2019
medline: 26 7 2019
Statut: ppublish

Résumé

How to safely treat pregnant women with epilepsy is a question for which there are guidelines, but variations in practice exist. To better characterize how clinicians address this difficult clinical question, we distributed an anonymous survey to neurology practitioners across subspecialties and different levels of training via the The results of this survey demonstrate a wide range in the amount of folic acid recommended and the frequency of checking levels of anti-epileptic drugs. Choice of first-line agent varied by the economic development status of the respondent's country, suggesting that access to medications plays an important role in clinical decision making in many parts of the world. This survey highlights several areas where further research would be helpful in guiding practice.

Sections du résumé

BACKGROUND BACKGROUND
How to safely treat pregnant women with epilepsy is a question for which there are guidelines, but variations in practice exist.
METHODS METHODS
To better characterize how clinicians address this difficult clinical question, we distributed an anonymous survey to neurology practitioners across subspecialties and different levels of training via the
RESULTS RESULTS
The results of this survey demonstrate a wide range in the amount of folic acid recommended and the frequency of checking levels of anti-epileptic drugs. Choice of first-line agent varied by the economic development status of the respondent's country, suggesting that access to medications plays an important role in clinical decision making in many parts of the world.
CONCLUSION CONCLUSIONS
This survey highlights several areas where further research would be helpful in guiding practice.

Identifiants

DOI: 10.1212/CPJ.0000000000000642 PMID: 31341707 PMC: PMC6615647
pubmed: 31341707
doi: 10.1212/CPJ.0000000000000642
pii: NEURCLINPRACT2018033423
pmc: PMC6615647
doi:

Types de publication

Journal Article

Langues

eng

Pagination

201-207

Références

J Neurol. 2008 Dec;255(12):1926-31
pubmed: 18677647
J Neurol Neurosurg Psychiatry. 2009 May;80(5):506-11
pubmed: 18977812
Neurology. 2009 Jul 14;73(2):133-41
pubmed: 19398681
Epilepsia. 2009 May;50(5):1247-55
pubmed: 19507305
Bull World Health Organ. 2010 Apr;88(4):260-6
pubmed: 20431789
Epilepsy Curr. 2010 Jul;10(4):75-9
pubmed: 20697498
Lancet Neurol. 2011 Jul;10(7):609-17
pubmed: 21652013
Lancet Neurol. 2013 Mar;12(3):244-52
pubmed: 23352199
Seizure. 2014 Jan;23(1):77-80
pubmed: 24120315
J Neurol Neurosurg Psychiatry. 2014 Sep;85(9):1029-34
pubmed: 24444855
Continuum (Minneap Minn). 2014 Feb;20(1 Neurology of Pregnancy):60-79
pubmed: 24492811
Epilepsy Behav. 2014 Apr;33:49-53
pubmed: 24632353
Cochrane Database Syst Rev. 2014 Oct 30;(10):CD010236
pubmed: 25354543
Neurology. 2015 Jan 27;84(4):382-90
pubmed: 25540307
Seizure. 2015 Apr;27:51-3
pubmed: 25891927
PLoS One. 2015 Jul 06;10(7):e0131130
pubmed: 26147467
Epilepsia. 2016 Aug;57(8):e173-7
pubmed: 27319360
Cochrane Database Syst Rev. 2016 Nov 14;11:CD001031
pubmed: 27841445
Neurology. 2017 Feb 21;88(8):728-733
pubmed: 28122902
Neurol Clin Pract. 2017 Aug;7(4):363-371
pubmed: 29185530
JAMA Neurol. 2018 Feb 1;75(2):160-168
pubmed: 29279889
JAMA Neurol. 2018 Jun 1;75(6):663-671
pubmed: 29459981
Epilepsy Behav. 2018 Jul;84:10-14
pubmed: 29730500
Obstet Gynecol Clin North Am. 2018 Jun;45(2):349-367
pubmed: 29747735

Auteurs

Ilena C George (IC)

Corinne Goldsmith Dickinson Center for Multiple Sclerosis (ICG), Mount Sinai, New York, NY; Clinical Epilepsy Section (LB), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Center for Neuroscience (LB), George Washington University, Children's National Health System; Center for Healthcare Organization and Implementation Research (JN), Edith Nourse Rogers Memorial VA, Bedford, MA; and Department of Neurology (DS), University of Oklahoma.

Luca Bartolini (L)

Corinne Goldsmith Dickinson Center for Multiple Sclerosis (ICG), Mount Sinai, New York, NY; Clinical Epilepsy Section (LB), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Center for Neuroscience (LB), George Washington University, Children's National Health System; Center for Healthcare Organization and Implementation Research (JN), Edith Nourse Rogers Memorial VA, Bedford, MA; and Department of Neurology (DS), University of Oklahoma.

John Ney (J)

Corinne Goldsmith Dickinson Center for Multiple Sclerosis (ICG), Mount Sinai, New York, NY; Clinical Epilepsy Section (LB), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Center for Neuroscience (LB), George Washington University, Children's National Health System; Center for Healthcare Organization and Implementation Research (JN), Edith Nourse Rogers Memorial VA, Bedford, MA; and Department of Neurology (DS), University of Oklahoma.

Divya Singhal (D)

Corinne Goldsmith Dickinson Center for Multiple Sclerosis (ICG), Mount Sinai, New York, NY; Clinical Epilepsy Section (LB), National Institute of Neurological Disorders and Stroke, Bethesda, MD; Center for Neuroscience (LB), George Washington University, Children's National Health System; Center for Healthcare Organization and Implementation Research (JN), Edith Nourse Rogers Memorial VA, Bedford, MA; and Department of Neurology (DS), University of Oklahoma.

Classifications MeSH