They were not given vitamin K, and no statistically significant difference was found concerning the risk of intracerebral bleeding compared with healthy controls. Genetic BKM120 in vitro epilepsy risk If one excludes epilepsy syndromes with a very high genetic preponderance, such as benign familial newborn seizures, juvenile myoclonic epilepsy, tuberous sclerosis, and others,98 Inhibitors,research,lifescience,medical the general risk of suffering from epileptic seizures during the first 20 years of life is 8.7% in case of a maternal
and 2.4% in case of a paternal epilepsy.99 Idiopathic epilepsies are associated with an epilepsy risk in the children of between 5% and 20%; this reaches 25% if both parents are affected.24 Patients with epilepsy should make use of the possibilities of human genetic counseling in order to estimate the individual risk of epilepsy in their children. Postnatal period After delivery one has to consider reducing AED dosage again, if it has had to be Inhibitors,research,lifescience,medical reduced during
pregnancy, to avoid postnatal intoxication of the mother. There is no general contraindication for breastfeeding. Since the children were exposed to the AED of the mother during pregnancy, breastfeeding may even help to avoid with-drawal symptoms in the child, Inhibitors,research,lifescience,medical since almost all AEDs are transported by breast milk.24 The concentrations range widely and depend of the AED plasma protein binding.24,71,100 The most frequent problem with breastfeeding may be sedation of the child, with consequent, sucking weakness. Among the new AEDs the milk/serum level is 0.6.101 Nevertheless, in children therapeutic ranges of LTG have been measured, due to the reduced metabolism of the
drug in newborns.102 Inhibitors,research,lifescience,medical Since LTG is among the most frequently used AEDs in pregnancy,81,82,96,103 the behavior of the child should be watched Inhibitors,research,lifescience,medical carefully. This is certainly a general rule beyond pure LTG treatment. Although the recommendations vary widely,100 for the classical AEDs there are no concerns about CBZ, PHT, and VPA.104 Breastfeeding is also possible during the use of PB, PRM, and benzodiazepines, although the rate of sedation and sucking disturbances may be higher.100,104,105 Liothyronine Sodium Close clinical monitoring is recommended in the case of PB and ethosuximidc, which is highly concentrated in breast milk and occasionally reaches the same levels as in the maternal blood.100 FBM is also considered to be required in order to satisfactorily judge the suitability of new AEDs for breastfeeding.100,105 Teratogenicity The risk of malformation is increased in children of mothers with epilepsy. Most references report malformation rates that are two to three times higher than in the normal population.71,100,106,110 The maximum range varies between a 1.25-fold and a fivefold elevated risk.111,112 One differentiates between minor and major congenital abnormalities.