Seizure-European Journal of Epilepsy最新文献

{"title":"Drug reaction with eosinophilia and systemic symptoms (DRESS) associated with the use of antiseizure medications—An overview of clinical data","authors":"Naina Mohamed Pakkir Maideen ,&nbsp;Krishnaveni Kandasamy ,&nbsp;Rajkapoor Balasubramanian ,&nbsp;Ananda Thangadurai Subramani","doi":"10.1016/j.seizure.2024.12.020","DOIUrl":"10.1016/j.seizure.2024.12.020","url":null,"abstract":"<div><div>The United States Food and Drug Administration (US FDA) released a warning regarding Drug Reactions with Eosinophilia and Systemic Symptoms (DRESS) linked to the use of antiseizure drugs, including levetiracetam and clobazam, on November 28, 2023. Hence, our review focuses on DRESS associated with the use of antiseizure drugs, including Levetiracetam, Clobazam, Carbamazepine, Phenytoin, Phenobarbital, Valproate, Oxcarbazepine, and Lamotrigine. The online databases, such as Medline/Pubmed/PMC, Scopus, Web of Science, Google Scholar, Science Direct, Ebsco, Embase, and reference lists, were searched for relevant publications. Several case reports and reviews of pharmacovigilance data by different regulatory bodies were published regarding DRESS associated with antiseizure drugs. Management strategies for DRESS may include immediate discontinuation of offending medication, administration of systemic corticosteroids, and administration of cyclosporine and intravenous immunoglobulin in cases that are not responding to systemic corticosteroids. Early detection and treatment of DRESS by healthcare professionals is necessary to lower mortality and improve outcomes. The US FDA advises healthcare professionals to be aware of the connection between DRESS and specific antiseizure medications. Patients should be informed by medical professionals about the symptoms and signs of DRESS as well as the risks associated with it. In conclusion, DRESS syndrome, though rare, is a serious hypersensitivity reaction linked to antiseizure drugs like levetiracetam and clobazam. Early detection and discontinuation of the offending drug, coupled with systemic corticosteroids, are essential for effective management. Healthcare professionals must be vigilant in identifying DRESS to reduce mortality and improve patient outcomes.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 118-131"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Top Ten epilepsy research priorities: A UK priority setting partnership","authors":"Anna C Norton ,&nbsp;Caoimhe Twohig-Bennett ,&nbsp;Maxine Smeaton ,&nbsp;Anthony Marson ,&nbsp;Jack Armstrong ,&nbsp;Adam Kovac ,&nbsp;Samantha Ashby ,&nbsp;Hannah Cock ,&nbsp;Anne Coxon ,&nbsp;Jon M Dickson ,&nbsp;Abbie Fearon ,&nbsp;Alison Fuller ,&nbsp;Michael Kinney ,&nbsp;Andrée Mayne ,&nbsp;Tom McLaughlan ,&nbsp;James W Mitchell ,&nbsp;Rosemarie Pardington ,&nbsp;Angie Pullen ,&nbsp;Rohit Shankar ,&nbsp;Juliet Solomon ,&nbsp;Rhys H Thomas","doi":"10.1016/j.seizure.2024.12.008","DOIUrl":"10.1016/j.seizure.2024.12.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Research into epilepsy has experienced decades of chronic underfunding compared to other neurological conditions despite its prevalence and seriousness. To evidence the need for greater investment, the Epilepsy Research Institute (formerly Epilepsy Research UK) funded, led and managed a James Lind Alliance (JLA) Priority Setting Partnership (PSP). This “industry standard” methodology brings together healthcare professionals, patients, carers and patient group representatives to identify and prioritise research uncertainties within a defined area of health or care.</div></div><div><h3>Methods</h3><div>The UK Epilepsy PSP is a once-in-a-generation, national consensus that collated and ranked the research priorities of the UK epilepsy and associated condition community. Following JLA methodology, this 18-month project engaged over 100 patient groups and 5000 people affected by and working in epilepsy, including medics and allied healthcare professionals, from across the UK.</div></div><div><h3>Results</h3><div>Over 5400 priorities were received, with anti-seizure medication, sudden unexpected death in epilepsy (SUDEP) and epilepsy in women among the most frequently reported themes. The responses received were categorised and translated into distinct, researchable questions. Questions were excluded if deemed to be “answered” following an evidence check, while research uncertainties (i.e. unanswered and partially answered questions) formed the basis of a second, shortlisting survey. The shortlisted questions were then discussed and debated at the final workshop by participants that broadly represented the UK epilepsy and associated condition community. The final ranking and Top Ten priorities for research into epilepsy were then agreed.</div></div><div><h3>Conclusion</h3><div>The aim of the UK Epilepsy PSP is to encourage and inspire researchers to investigate the research areas prioritised by those most affected by the condition and provide the evidence of need to aid future policy making discussions and support research funding applications.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 152-161"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A call for better information about epilepsy: The next of kin perspective","authors":"Frida Knutstad Rusten ,&nbsp;Karl O. Nakken ,&nbsp;Morten I. Lossius ,&nbsp;Oliver Henning","doi":"10.1016/j.seizure.2024.12.012","DOIUrl":"10.1016/j.seizure.2024.12.012","url":null,"abstract":"<div><h3>Purpose</h3><div>For next of kin (NK) to people with epilepsy (PWE) insufficient knowledge about the disease might have a negative impact on disease management, utilization of the health care system and conveyance of attitudes in the society. The aim of this study was to investigate to which degree Norwegian NK to PWE called for and obtained relevant information about different epilepsy-related issues.</div></div><div><h3>Methods</h3><div>We invited NK visiting the homepage of the Norwegian Epilepsy Association to complete an online questionnaire regarding information about epilepsy. The survey was accessible for a five-month period.</div></div><div><h3>Results</h3><div>231 NK fulfilled the questionnaire. Almost 90 % of the respondents called for more information about specific topics, such as seizure management and premature death in epilepsy, in addition to more general information about the disease. Those who experienced high levels of psychological distress were particularly in need of more information about all epilepsy-related issues. Depending on the subject, the proportion of respondents that reported not to have obtained information on specific issues varied from 42 % to 88 %. Good seizure control in the person they cared for was significantly associated with receiving insufficient information about seizure management, seizure-related injuries, concentration and memory, and borderline significant about depression and anxiety.</div></div><div><h3>Significans</h3><div>The majority of Norwegian NK to PWE call for more and better information about the disease. Perceived lack of information among close relatives was associated with high levels of emotional stress. This should be a wake-up call for healthcare professionals working with this patient group.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"125 ","pages":"Pages 10-15"},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infantile Epileptic Spasms Syndrome: Unveiling clinical and genetic variability in a case series from Argentina","authors":"María Eugenia Martín ,&nbsp;Lenin Intriago ,&nbsp;Mariana Loos ,&nbsp;Gabriela Reyes Valenzuela ,&nbsp;Gabriel Veneruzzo ,&nbsp;María Eugenia Foncuberta ,&nbsp;Gabriela Zelaya ,&nbsp;Giovanna Aschettino ,&nbsp;Francisco García ,&nbsp;Giovanna Flores ,&nbsp;Roberto Caraballo ,&nbsp;Cristina Alonso ,&nbsp;Matías Juanes","doi":"10.1016/j.seizure.2025.01.025","DOIUrl":"10.1016/j.seizure.2025.01.025","url":null,"abstract":"<div><h3>Purpose</h3><div>Infantile Epileptic Spasms Syndrome (IESS) is the most prevalent epileptic encephalopathy (EE) in the first year of life, with approximately 40 % of cases of genetic or unknown origin. This study aims to describe the clinical and molecular characteristics of a group of Argentine patients diagnosed with IESS of unknown etiology.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on the clinical data of 24 pediatric patients diagnosed with IESS with hypsarrhythmia, who underwent genomic studies between 2019 and 2022.</div></div><div><h3>Results</h3><div>A genetic etiology was identified in 50 % of cases (eight boys and four girls; median seizure onset age: 3 months). Most of them initiated with IESS and over half evolved into Lennox-Gastaut syndrome. Developmental delay preceded seizure onset in all patients, persisting or worsening thereafter. Notable features included hypotonia, microcephaly, and dysmorphisms. Half of the patients had a family history of epilepsy, and two of EE. Identified variants included 7/13 (53.8 %) single nucleotide variants in <em>KCNQ2, STXBP1, SCN8A, CDKL5, UGDH</em>, and <em>WWOX</em>; 5/13 (38.5 %) copy number variants involving the genes <em>UBE3A-GABRB3-GABRA5, SCN2A-SCN1A-SCN9A</em>, and <em>WWOX</em>; and a short tandem repeat in <em>ARX</em>. Inheritance patterns included autosomal dominant (<em>n</em> = 8), recessive (<em>n</em> = 2), and X-linked (<em>n</em> = 2). Nine variants (69.2 %) were presumed <em>de novo</em>.</div></div><div><h3>Conclusion</h3><div>These findings underscore the extensive genetic heterogeneity of IESS within the Argentine population, enriching the international literature and variant databases with Latin American data. In cases with an unknown cause, genetic testing is crucial in establishing an etiological diagnosis, guiding appropriate treatment, and facilitating genetic counseling.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 48-57"},"PeriodicalIF":2.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143377551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac arrest following lacosamide intoxication in an adolescent; a case report","authors":"Gen Furukawa ,&nbsp;Shun Imamura ,&nbsp;Ayami Yoshikane ,&nbsp;Hidetoshi Uchida ,&nbsp;Kazuyoshi Saito ,&nbsp;Tadayoshi Hata ,&nbsp;Naoko Ishihara","doi":"10.1016/j.seizure.2025.01.023","DOIUrl":"10.1016/j.seizure.2025.01.023","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 76-78"},"PeriodicalIF":2.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143394337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical profile of adult-onset idiopathic generalised epilepsy","authors":"Javier Peña-Ceballos ,&nbsp;Patrick B. Moloney ,&nbsp;Tenzin Choekyi ,&nbsp;Hany El Naggar ,&nbsp;Peter Widdess-Walsh ,&nbsp;Norman Delanty","doi":"10.1016/j.seizure.2025.01.024","DOIUrl":"10.1016/j.seizure.2025.01.024","url":null,"abstract":"<div><h3>Objective</h3><div>Idiopathic generalised epilepsies (IGE) tend to begin in childhood or adolescence, whereas adult-onset presentations are less frequently observed. In this study, we describe the disease course of a cohort of patients with adult-onset IGE.</div></div><div><h3>Methods</h3><div>In this retrospective observational study, we evaluated clinical features, seizure outcomes, and antiseizure medication (ASM) prescribing trends in a cohort of IGE patients with seizure onset aged 18 years or older.</div></div><div><h3>Results</h3><div>In a cohort of 425 IGE patients, we identified 55 with adult-onset IGE (12.9 %). Forty-nine patients (89.1 %) experienced seizure onset between ages 18 and 30 years, while the remaining six patients (10.9 %) had onset after the age of 30 years. Eleven patients were initially diagnosed with focal epilepsy (20 %). Most patients (98.2 %) initially presented with generalised tonic-clonic seizures (GTCS). Epilepsy with generalised tonic-clonic seizures alone (GTCA) was the most common syndrome (65.4 %). Thirty-five patients (63.6 %) were treated with ASM monotherapy, 17 (30.9 %) with polytherapy, and three (5.4 %) were not taking any ASM. Lamotrigine, levetiracetam (38.2 %), and valproate (27.3 %) were the most prescribed ASMs. At last clinical review, 40 patients (72.7 %) were seizure-free (no seizures for ≥12 months), including those with absence seizures and myoclonic seizures, and 46 were free of GTCS for a mean duration of 6.2 years (range 1–21 years). Eight patients (14.5 %) had drug-resistant epilepsy (DRE). Eight patients attempted ASM withdrawal, with seizure recurrence occurring in six (75 %), with the period off ASM ranging from one week to 26 years.</div></div><div><h3>Significance</h3><div>IGE should be considered as a possible diagnosis in people who first present with convulsive seizures in adulthood, particularly those aged between 18 and 30 years with normal neuroimaging. Adult-onset IGE has a good prognosis overall, with most people becoming seizure-free, although the risk of seizure recurrence appears to be high after ASM withdrawal. A minority develop DRE and require polytherapy with ≥2 ASMs.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 24-31"},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143285084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing machine learning techniques for EEG assessment in the diagnosis of epileptic seizures in the brain: A systematic review and meta-analysis","authors":"Dikshit Chawla ,&nbsp;Eshita Sharma ,&nbsp;Numa Rajab ,&nbsp;Paweł Łajczak ,&nbsp;Yasmin P. Silva ,&nbsp;João Marcelo Baptista ,&nbsp;Beatriz W. Pomianoski ,&nbsp;Aisha R. Ahmed ,&nbsp;Mir wajid Majeed ,&nbsp;Yan G. de Sousa ,&nbsp;Manoela L. Pinto ,&nbsp;Oğuz K. Sahin ,&nbsp;Muhaison H. Ibrahim ,&nbsp;Idrys H.L. Guedes ,&nbsp;Anoushka Chatterjee ,&nbsp;Ramon Guerra Barbosa ,&nbsp;Walter Fagundes","doi":"10.1016/j.seizure.2025.01.021","DOIUrl":"10.1016/j.seizure.2025.01.021","url":null,"abstract":"<div><h3>Purpose</h3><div>Advancements in Machine Learning (ML) techniques have revolutionized diagnosing and monitoring epileptic seizures using Electroencephalogram (EEG) signals. This analysis aims to determine the effectiveness of ML techniques in recognizing patterns of epileptic seizures in the brain using EEG signals.</div></div><div><h3>Methods</h3><div>We searched PubMed, Scopus, and Google Scholar for relevant RCTs, cohort studies, and case-control studies involving patients with prior epileptic seizures who underwent EEG analysis aided by ML techniques. Using the STATA software, we evaluated the accuracy of predicting epileptic seizures, measured using metrics such as Area under the curve (AUC), Sensitivity, and Specificity.</div></div><div><h3>Results</h3><div>The random effects bivariate model of 4 studies with 214 patients revealed high diagnostic performance for ML techniques in detecting epileptic signals in EEGs. The estimated sensitivity was 0.97 (95 % CI: 0.92–0.99), indicating its ability to accurately detect the condition in 97 % of cases. Similarly, the estimated specificity was 0.99 (95 % CI: 0.98–0.99), demonstrating its ability to correctly identify the absence of the condition in 99 % of cases. There was also a high AUC (1.00, 95 % CI: 0.99–1.00), indicating ML techniques can distinguish epileptic seizures from no seizures in EEG signals 100 % of the time. These findings underscore the test's robust diagnostic utility in sensitivity and specificity. There was a significant between-study variability (heterogeneity) with a chi-square p-value &lt;0.001 and an I² value of 95 %. A bivariate box plot further confirmed the heterogeneity. Deek's test for publication bias showed a non-significant p-value (<em>p</em> = 0.06) indicating the absence of publication bias.</div></div><div><h3>Conclusion</h3><div>ML techniques can potentially enhance diagnostic accuracy in epilepsy detection, offering valuable insights into developing advanced diagnostic tools for clinical practice.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 16-23"},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143169714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse events of dual anti-seizure medication: Real-life data from a tertiary epilepsy clinic","authors":"Alexander B. Kowski,&nbsp;Sophie Schlabitz,&nbsp;David Steinbart,&nbsp;Martin Holtkamp ,&nbsp;Verena Gaus","doi":"10.1016/j.seizure.2025.01.022","DOIUrl":"10.1016/j.seizure.2025.01.022","url":null,"abstract":"<div><h3>Objective</h3><div>In patients with epilepsy, adverse events (AE) of anti-seizure medication (ASM) may lead to unfavorable quality of life and non-adherence to treatment. This retrospective study aimed to identify risk factors for overall AE burden and specific AE in patients with dual ASM therapy.</div></div><div><h3>Methods</h3><div>All patients aged at least 18 years from a tertiary epilepsy outpatient clinic routinely complete the 19-item Liverpool Adverse Events Profile (LAEP). Demographic, epilepsy, and treatment variables were extracted from our outpatient database. Variables of clinical relevance were entered into a binary logistic regression model.</div></div><div><h3>Results</h3><div>Out of 2,106 patients, dual ASM was applied to 595 patients with 98 different combinations. We focused on the five most frequent ASM combinations; levetiracetam and lamotrigine (LEV/LTG, n=108), lacosamide and levetiracetam (LCM/LEV, n=53), lamotrigine and valproic acid (LTG/VPA, n=50), levetiracetam and valproic acid (LEV/VPA, n=27), and eslicarbazepine acetate and levetiracetam (ESL/LEV, n=22). Commonly reported specific AE were sleepiness (62 %), difficulty concentrating (55 %), memory problems (53 %), tiredness (46 %), and disturbed sleep (40 %). Relevant AE burden (LAEP score ≥45) was independently associated with female sex, LEV/VPA- and LTG/VPA-dual therapy, drug resistance, as well as focal and unclassified epilepsy. Distinct AE were associated mainly with female sex (6/19 AE), focal (5/19 AE), unclassified (7/19 AE) epilepsy, and drug resistance (4/10 AE). Concerning specific AE combination, only LTG/VPA was independently associated with hair loss (OR 6.766).</div></div><div><h3>Significance</h3><div>After controlling for potential confounders, our study found that the two ASM combinations involving valproic acid were significantly associated with higher LAEP scores, indicating poorer tolerability. Specific adverse events, such as hair loss, were independently associated with the LTG/VPA combination. Cognitive side effects were notably prominent across all five dual ASM combinations. While dual ASM therapy is associated with an increased burden of AE, this increase appears to be moderate when therapies are individually tailored. Increased awareness and systematic screening of AE, particularly cognitive side effects, are essential to optimize treatment outcomes.</div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 86-94"},"PeriodicalIF":2.7,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Education and empathy through cinema: Lessons from seizure: The medical treatment and social problems of epilepsy (1951)","authors":"Francesco Brigo","doi":"10.1016/j.seizure.2025.01.020","DOIUrl":"10.1016/j.seizure.2025.01.020","url":null,"abstract":"","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 14-15"},"PeriodicalIF":2.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is lamotrigine a teratogen?","authors":"Frank JE Vajda ,&nbsp;Simon R L Vajda ,&nbsp;Mervyn J Eadie","doi":"10.1016/j.seizure.2025.01.019","DOIUrl":"10.1016/j.seizure.2025.01.019","url":null,"abstract":"<div><h3>Aim</h3><div>To assess whether lamotrigine (Lamictal), when used in antiseizure medication (ASM) monotherapy, is a teratogen.</div></div><div><h3>Materials/Methods</h3><div>Analysis of data from 490 LTG monotherapy treated pregnancies and 214 pregnancies in women with epilepsy not exposed to any antiseizure medications during at least the first half of pregnancy.</div></div><div><h3>Results</h3><div>The LTG-treated and the untreated pregnancies were well matched in nearly all regards apart from ASM exposure. There was a foetal malformation (FM) occurrence rate of 4.49 % in the LTG-exposed pregnancies and 3.27 % in the untreated pregnancies (Risk Ratio = 1.37; 95 % C.I. 0.60, 3.16). Logistic regression produced no evidence that the extent of the LTG-associated malformation occurrence hazard was LTG dose related. However, the malformation-affected body regions tended to differ between the LTG-treated and untreated pregnancies.</div></div><div><h3>Conclusion</h3><div>The above findings do not reach a statistically significant level (<em>P</em> &lt; 0.05) but, taken overall, they do not necessarily exclude the possibility that LTG may be a weak teratogen. If LTG monotherapy-associated foetal malformation occurrence rates are used as the comparator against which to evaluate the foetal malformation hazards associated with other ASMs, the findings may possibly be open to the risk of falsely reassuring outcomes<strong>.</strong></div></div>","PeriodicalId":49552,"journal":{"name":"Seizure-European Journal of Epilepsy","volume":"126 ","pages":"Pages 1-5"},"PeriodicalIF":2.7,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143041396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}