Valproate taken during pregnancy linked to autism risk.
Posted by on May 8, 2013 - 12:08pm

Women who take valproate (Depacon) during pregnancy may increase the risk of childhood autism and its spectrum disorders in their children, a population-based study showed.

In utero exposure to the drug was associated with a five-fold elevated risk of autism and three-fold elevated risk for autism spectrum disorder, Jakob Christensen, PhD, of Denmark's Aarhus University Hospital, and colleagues found.

The absolute risks were 2.5% and 4.4%, respectively, and remained significantly elevated after adjustment for parents' epilepsy and psychiatric disease, the group reported in the April 24 issue of the Journal of the American Medical Association.

"For women of childbearing potential who use anti-epileptic medications, these findings must be balanced against the treatment benefits for women who require valproate for epilepsy control," they concluded.  But "because autism spectrum disorders are serious conditions with lifelong implications for affected children and their families, even a moderate increase in risk may have major health importance," they added.

The American Academy of Neurology recommends avoiding valproate in pregnancy whenever possible due to cognitive and physical birth defect problems for children exposed in utero.

The additional risk of autism and spectrum disorders needs to be included in counseling for women now too, Kimford Meador, MD, and David Loring, PhD, both of Emory University in Atlanta, recommended in an accompanying editorial.

"Because approximately half of the pregnancies in the U.S. are unplanned, delaying discussions of treatment risks until a pregnancy is considered will leave a substantial number of children at unnecessary risk," they warned. "Women of childbearing potential should be informed of the potential risks of fetal valproate exposure before valproate is prescribed."

The drug has an indication for manic and mixed episodes in bipolar disorder and for migraine prevention in addition to seizure control.

Primary source: Journal of the American Medical Association

 

Women with neurologic issues need specialized care
Posted by on October 27, 2012 - 7:49am

Conditions that affect the brain can be more complicated in women compared to men, partly because of hormones and reproductive issues.   Did you know:

  • Twenty percent of women have migraines
  • Primary care doctors often ignore sleep disorders in women
  • Epilepsy and its treatment can be impacted by hormonal cyclic changes
  • Neurologic treatments interfere with contraceptive effectiveness and fertility
  • Stroke mortality is higher in women than men but 30% of women are unaware of this fact.

To address these concerns at NorthwesternMedicine, a group of neurology specialists who have a strong interest in women's health and sex-specific care have opened the Women's Neurology Clinic at Northwestern.  The center plans to incorporate integrated medicine approaches and  not rely solely on pharmacologic interventions.    To learn more about this clinic, visit their website.

 

Menstrual cycle hormones influence seizure frequency
Posted by on July 21, 2011 - 8:12am

Monthly hormone cycle changes

Researchers are exploring how hormone levels impact certain brain activity during the menstrual cycle and the results may influence how birth control pills doses are prescribed to women with conditions like epilepsy in the future.

Increased levels of certain reproductive steroids correspond to more frequent generalized tonic-clonic seizures (GTCS) in women with epilepsy, according to new research from Beth Israel Deaconess Medical Center in Boston.

Scientists found that female epilepsy patients had 30 percent more GTCS a day during anovulatory cycles (menstrual cycles where an egg is not released) than during ovulatory cycles. Previous research has shown that anovulatory cycles are associated with higher levels of the sex hormones estradiol and progesterone.

Study author Andrew Herzog and colleagues analyzed data from the three-month Progesterone Trial Study, which investigated the use of progesterone therapy for focal onset seizures. Of the 281 women who participated in the study, 92 had both ovulatory and anovulatory cycles during the study. Only the daily frequency of GTCS, and not that of complex partial seizures or simple partial seizures, increased significantly during anovulatory cycles.

Other studies have shown that women with epilepsy are more likely to have anovulatory cycles than women who don't have epilepsy. The research was published July 14 in the journal Epilepsia.