癫痫和妊娠_West China Medical Journal

Authors：

 龙燕玲 , 周娟 ,  邹晓毅

四川大学华西医院神经内科（成都，610041）;

Corresponding author：

邹晓毅, Email: xiaoyizou@163.com

Keywords：

癫痫; 妊娠; 抗癫痫药物; 致畸

DOI：

10.7507/1002-0179.20140049

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

癫痫严重影响患者的生活质量，特别是对孕妇这一特殊群体。女性癫痫患者（WWE）妊娠后体内环境发生变化，常常导致癫痫恶化。痫性发作本身和抗癫痫药物不仅可以对孕妇造成严重影响，而且可以引起胎儿发育异常。目前，关于育龄期和围生期WWE患者避孕、抗癫痫药物应用、叶酸补充、哺乳等方面的文献比较分散。现对相关资料作一综述，以提高临床工作者对这一特殊领域的关注，并为临床实践提供参考。

Citation： 龙燕玲, 周娟, 邹晓毅. 癫痫和妊娠. West China Medical Journal, 2014, 29(1): 160-163. doi: 10.7507/1002-0179.20140049 Copy

1.	潘敏翔, 吴久鸿, 郭丽. 抗癫药的药物经济学研究[J]. 药品评价, 2011, 8(20):30-34.
2.	The Lancet Neurology. EURAP Signals a new era in epilepsy research[J]. Lancet Neurol, 2011, 10(7):591.
3.	Thomas SV, Syam U, Devi JS. Predictors of seizures during pregnancy in women with epilepsy[J]. J Sucharitha Devi Epilepsia, 2012, 53(5):85-88.
4.	Kulaga S, Sheehy O, Zargarzadeh AH,et al. Antiepileptic drug use during pregnancy:perinatal outcomes[J]. Seizure, 2011, 20(9):667-672.
5.	Borthen I, Eide M, Daltveit A, et al. Obstetric outcome in women with epilepsy:a hospital-based, retrospective study[J]. BJOG, 2011, 118(8):956-965.
6.	Naseer MI, Shupeng L, Kim MO. Maternal epileptic seizure induced by pentylenetetrazol:apoptotic neurodegeneration and decreased GABAB1 receptor expression in prenatal rat brain[J]. Mol Brain, 2009(2):20.
7.	Harden CL, Leppik I. Optimizing therapy of seizures in women who use oral contraceptives[J]. Neurology, 2006, 67(12, Suppl 4):56-58.
8.	Johannessen Landmark C, Patsalos PN. Drug interactions involving the new second- and third-generation antiepileptic drugs[J]. Expert Rev Neurother, 2010, 10(1):119-140.
9.	Ragueneau-Majlessi I, Levy RH, Janik F. Levetiracetam does not alter the pharmacokinetics of an oral contraceptive in healthy women[J]. Epilepsia, 2002, 43(7):697-702.
10.	Sabers A, Christensen J. No effect of oral contraceptives on the metabolism of levetiracetam[J]. Epilepsy Res, 2011, 95(3):277-279.
11.	Vajda FJ, Hitchcock A, Graham J, et al. Seizure control in antiepileptic drug-treated pregnancy[J]. Epilepsia, 2008, 49(1):172-176.
12.	Aberd EU, Obst D, Lond RWS, et al. Folic acid metabolism and human embryopathy[J]. Lancet, 1965, 285(7398):1254-1256.
13.	Bauer J, Bös M, Rück J, et al. Evaluation of folate substitution in women with epilepsy. Determination of erythrocyte folic acid concentrations[J]. Der Nervenarzt, 2011, 82(4):459-461.
14.	Pittschieler S, Brezinka C, Jahn B, et al. Spontaneous abortion and the prophylactic effect of folic acid supplementation in epileptic women undergoing antiepileptic therapy[J]. J Neur, 2008, 255(12):1926-1931.
15.	Hernández-Díaz S, Smith CR, Shen A, et al. Comparative safety of antiepileptic drugs during pregnancy[J]. Neurology, 2012, 78(21):1692-1699.
16.	Vajda FJ, Graham JE, Hitchcock AA, et al. Is lamotrigine a significant human teratogen? Observations from the Australian Pregnancy Register[J]. Seizure, 2010, 19(9):558-561.
17.	Tomson T, Battino D, Bonizzoni E, et al. Dose-dependent risk of malformations with antiepileptic drugs:an analysis of data from the EURAP epilepsy and pregnancy registry[J]. Lancet Neurol, 2011, 10(7):609-617.
18.	Sabers A, Petrenaite V. Seizure frequency in pregnant women treated with lamotrigine monotherapy[J]. Epilepsia, 2009, 50(9):2163-2166.
19.	Sabers A. Algorithm for lamotrigine dose adjustment before, during and after pregnancy[J]. Acta Neurol Scand, 2012, 126(1):1-4.
20.	Ozer FD, Demirel A, Yılmaz Dilsiz O, et al. Effects of Levetiracetam on neural tube development and closure of the chick embryos in ovo[J]. Childs Nerv Syst, 2012, 28(7):969-976.
21.	Longo B, Forinash AB, Murphy JA. Levetiracetam use in pregnancy[J]. Ann Pharmacother, 2009, 43(10):1692-1695.
22.	Ulloa CM, Towfigh A, Safdieh J. Review of levetiracetam, with a focus on the extended release formulation, as adjuvant therapy in controlling partial-onset seizures[J]. Neuropsychiatr Dis Treat, 2009(5):467-476.
23.	Tomson T, Palm R, Källén K, et al. Pharmacokinetics of levetiracetam during pregnancy, delivery, in the neonatal period, and lactation[J]. Epilepsia, 2007, 48(6):1111-1116.
24.	Montouris G. Safety of the newer antiepileptic drug oxcarbazepine during pregnancy[J]. Curr Med Res Opin, 2005, 21(5):693-701.
25.	Uludag S, Aydin Y, Yilmaz O. Multiple fetal anomalies in association with topiramate and oxcarbezepine treatment[J]. Fetal Pediatr Pathol, 2012, 31(3):154-158.
26.	Petrenaite V, Sabers A, Hansen-Schwartz J, et al. Seizure deterioration in women treated with oxcarbazepine during pregnancy[J]. Epilepsy Res, 2009, 84(2-3):245-249.
27.	Ohman I, Sabers A, de Flon P, et al. Pharmacokinetics of topiramate during pregnancy[J]. Epilepsy Res, 2009, 87(2-3):124-129.
28.	Westin AA, Nakken KO, Johannessen SI, et al. Serumconcentration/dose ratio of topiramate during pregnancy[J]. Epilepsia, 2009, 50(3):480-485.
29.	Prakash, Prabhu LV,Rai R, et al. Teratogenic effects of the anticonvulsant gabapentin in mice[J]. Singapore Med J, 2008, 49(1):47-53.
30.	Afshar M, Hassanzadeh-Taheri MM, Moallem SA, et al. Teratogenic effects of gabapentin on the skeletal system of Balb/C mice fetuses[J]. Neurosciences (Riyadh), 2009, 14(3):239-244.
31.	Ozkan H, Cetinkaya M, Köksal N, et al. Severe fetal valproate syndrome:combination of complex cardiac defect, multicystic dysplastic kidney, and trigonocephaly[J]. J Matern Fetal Neonatal Med, 2011, 24(3):521-524.
32.	Meador KJ, Baker GA, Browning N, et al. Effects of breastfeeding in children of women taking antiepileptic drugs[J]. Neurology, 2010, 75(22):1954-1960.
33.	Chen L, Liu F, Yoshida S, et al. Is breast-feeding of infants advisable for epileptic mothers taking antiepileptic drugs?[J] Psychiatry Clin Neurosci, 2010, 64(5):460-468.
34.	Sun Y, Vestergaard M, Christensen J, et al. Breastfeeding and risk of epilepsy in childhood:a birth cohort study[J]. J Pediatr, 2011, 158(6):924-929.
35.	Kazmin A, Wong RC, Sermer M, et al. Antiepileptic drugs in pregnancy and hemorrhagic disease of the newborn an update[J]. Can Fam Physician, 2010,56(12):1291-1292.
36.	Sabers A. Influences on seizure activity in pregnant women with epilepsy[J]. Epilepsy Behav, 2009, 15(2):230-234.

1. 潘敏翔, 吴久鸿, 郭丽. 抗癫药的药物经济学研究[J]. 药品评价, 2011, 8(20):30-34.
2. The Lancet Neurology. EURAP Signals a new era in epilepsy research[J]. Lancet Neurol, 2011, 10(7):591.
3. Thomas SV, Syam U, Devi JS. Predictors of seizures during pregnancy in women with epilepsy[J]. J Sucharitha Devi Epilepsia, 2012, 53(5):85-88.
4. Kulaga S, Sheehy O, Zargarzadeh AH,et al. Antiepileptic drug use during pregnancy:perinatal outcomes[J]. Seizure, 2011, 20(9):667-672.
5. Borthen I, Eide M, Daltveit A, et al. Obstetric outcome in women with epilepsy:a hospital-based, retrospective study[J]. BJOG, 2011, 118(8):956-965.
6. Naseer MI, Shupeng L, Kim MO. Maternal epileptic seizure induced by pentylenetetrazol:apoptotic neurodegeneration and decreased GABAB1 receptor expression in prenatal rat brain[J]. Mol Brain, 2009(2):20.
7. Harden CL, Leppik I. Optimizing therapy of seizures in women who use oral contraceptives[J]. Neurology, 2006, 67(12, Suppl 4):56-58.
8. Johannessen Landmark C, Patsalos PN. Drug interactions involving the new second- and third-generation antiepileptic drugs[J]. Expert Rev Neurother, 2010, 10(1):119-140.
9. Ragueneau-Majlessi I, Levy RH, Janik F. Levetiracetam does not alter the pharmacokinetics of an oral contraceptive in healthy women[J]. Epilepsia, 2002, 43(7):697-702.
10. Sabers A, Christensen J. No effect of oral contraceptives on the metabolism of levetiracetam[J]. Epilepsy Res, 2011, 95(3):277-279.
11. Vajda FJ, Hitchcock A, Graham J, et al. Seizure control in antiepileptic drug-treated pregnancy[J]. Epilepsia, 2008, 49(1):172-176.
12. Aberd EU, Obst D, Lond RWS, et al. Folic acid metabolism and human embryopathy[J]. Lancet, 1965, 285(7398):1254-1256.
13. Bauer J, Bös M, Rück J, et al. Evaluation of folate substitution in women with epilepsy. Determination of erythrocyte folic acid concentrations[J]. Der Nervenarzt, 2011, 82(4):459-461.
14. Pittschieler S, Brezinka C, Jahn B, et al. Spontaneous abortion and the prophylactic effect of folic acid supplementation in epileptic women undergoing antiepileptic therapy[J]. J Neur, 2008, 255(12):1926-1931.
15. Hernández-Díaz S, Smith CR, Shen A, et al. Comparative safety of antiepileptic drugs during pregnancy[J]. Neurology, 2012, 78(21):1692-1699.
16. Vajda FJ, Graham JE, Hitchcock AA, et al. Is lamotrigine a significant human teratogen? Observations from the Australian Pregnancy Register[J]. Seizure, 2010, 19(9):558-561.
17. Tomson T, Battino D, Bonizzoni E, et al. Dose-dependent risk of malformations with antiepileptic drugs:an analysis of data from the EURAP epilepsy and pregnancy registry[J]. Lancet Neurol, 2011, 10(7):609-617.
18. Sabers A, Petrenaite V. Seizure frequency in pregnant women treated with lamotrigine monotherapy[J]. Epilepsia, 2009, 50(9):2163-2166.
19. Sabers A. Algorithm for lamotrigine dose adjustment before, during and after pregnancy[J]. Acta Neurol Scand, 2012, 126(1):1-4.
20. Ozer FD, Demirel A, Yılmaz Dilsiz O, et al. Effects of Levetiracetam on neural tube development and closure of the chick embryos in ovo[J]. Childs Nerv Syst, 2012, 28(7):969-976.
21. Longo B, Forinash AB, Murphy JA. Levetiracetam use in pregnancy[J]. Ann Pharmacother, 2009, 43(10):1692-1695.
22. Ulloa CM, Towfigh A, Safdieh J. Review of levetiracetam, with a focus on the extended release formulation, as adjuvant therapy in controlling partial-onset seizures[J]. Neuropsychiatr Dis Treat, 2009(5):467-476.
23. Tomson T, Palm R, Källén K, et al. Pharmacokinetics of levetiracetam during pregnancy, delivery, in the neonatal period, and lactation[J]. Epilepsia, 2007, 48(6):1111-1116.
24. Montouris G. Safety of the newer antiepileptic drug oxcarbazepine during pregnancy[J]. Curr Med Res Opin, 2005, 21(5):693-701.
25. Uludag S, Aydin Y, Yilmaz O. Multiple fetal anomalies in association with topiramate and oxcarbezepine treatment[J]. Fetal Pediatr Pathol, 2012, 31(3):154-158.
26. Petrenaite V, Sabers A, Hansen-Schwartz J, et al. Seizure deterioration in women treated with oxcarbazepine during pregnancy[J]. Epilepsy Res, 2009, 84(2-3):245-249.
27. Ohman I, Sabers A, de Flon P, et al. Pharmacokinetics of topiramate during pregnancy[J]. Epilepsy Res, 2009, 87(2-3):124-129.
28. Westin AA, Nakken KO, Johannessen SI, et al. Serumconcentration/dose ratio of topiramate during pregnancy[J]. Epilepsia, 2009, 50(3):480-485.
29. Prakash, Prabhu LV,Rai R, et al. Teratogenic effects of the anticonvulsant gabapentin in mice[J]. Singapore Med J, 2008, 49(1):47-53.
30. Afshar M, Hassanzadeh-Taheri MM, Moallem SA, et al. Teratogenic effects of gabapentin on the skeletal system of Balb/C mice fetuses[J]. Neurosciences (Riyadh), 2009, 14(3):239-244.
31. Ozkan H, Cetinkaya M, Köksal N, et al. Severe fetal valproate syndrome:combination of complex cardiac defect, multicystic dysplastic kidney, and trigonocephaly[J]. J Matern Fetal Neonatal Med, 2011, 24(3):521-524.
32. Meador KJ, Baker GA, Browning N, et al. Effects of breastfeeding in children of women taking antiepileptic drugs[J]. Neurology, 2010, 75(22):1954-1960.
33. Chen L, Liu F, Yoshida S, et al. Is breast-feeding of infants advisable for epileptic mothers taking antiepileptic drugs?[J] Psychiatry Clin Neurosci, 2010, 64(5):460-468.
34. Sun Y, Vestergaard M, Christensen J, et al. Breastfeeding and risk of epilepsy in childhood:a birth cohort study[J]. J Pediatr, 2011, 158(6):924-929.
35. Kazmin A, Wong RC, Sermer M, et al. Antiepileptic drugs in pregnancy and hemorrhagic disease of the newborn an update[J]. Can Fam Physician, 2010,56(12):1291-1292.
36. Sabers A. Influences on seizure activity in pregnant women with epilepsy[J]. Epilepsy Behav, 2009, 15(2):230-234.

Previous Article
帕金森病冻结步态的研究进展
Next Article
新型抗炎介质消退素的生物效应及机制

West China Medical Journal

癫痫和妊娠

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content