Fetal Exposure to GABA‐Acting Antiepileptic Drugs Generates Hippocampal and Cortical Dysplasias

@article{Manent2007FetalET,
  title={Fetal Exposure to GABA‐Acting Antiepileptic Drugs Generates Hippocampal and Cortical Dysplasias},
  author={Jean-Bernard Manent and Isabel Jorquera and Iolanda Mazzucchelli and Antoine Depaulis and Emilio Perucca and Yehezkel Ben-Ari and Alfonso Represa},
  journal={Epilepsia},
  year={2007},
  volume={48}
}
Summary:  Purpose: The management of epilepsy during pregnancy entails a number of concerns. While seizures may affect adversely maternal and fetal outcome, antiepileptic drugs (AEDs) may increase the incidence of congenital abnormalities and possibly affect postnatal cognitive development in the offspring. Experimental animal studies can aid in assessing teratogenic features associated with individual AEDs and/or with seizures, and to identify the mechanisms involved. The purpose of this study… 
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This review will attempt to draw parallels between the existent animal models and human studies and important future research will be elucidated and possible new and emerging therapies will be discussed.
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In utero exposure to some antiepileptic drugs (AEDs) is associated with an increased risk of impaired cognitive development and Behavioral dysfunction including autistic spectrum disorder is also associated with maternal use of AEDs during pregnancy.
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TLDR
While evidence is still accruing, recent investigations suggest that exposure to select AEDs results in altered cognitive function later in development, and there is no evidence to suggest that additional folic acid supplementation ameliorates the increased risk of congenital malformations conferred by in utero AED exposure.
Neurodevelopmental Effects of Fetal Antiepileptic Drug Exposure
TLDR
Overall, children exposed to polytherapy prenatally appear to have worse cognitive and behavioral outcomes compared withChildren exposed to monotherapy, and with the unexposed, but most information available suggests that major poor cognitive outcomes should not be attributed to this medication.
Seizures and Antiepileptic Drugs: Does Exposure Alter Normal Brain Development in Animal Models?
TLDR
Experimental studies indicate that there are indeed effects of frequent or prolonged seizures on the brain development, but these effects vary as a function of the seizure/epilepsy model used, age of implementation, and associated conditions (such as inflammation).
The neurotoxic effects of prenatal gabapentin and oxcarbazepine exposure on newborn rats
  • Z. Erisgin, B. Ayas, J. Nyengaard, N. Ercument Beyhun, Y. Terzi
  • Medicine, Biology
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2019
TLDR
The result is that the OXC andGBP exposure at different gestational periods may not give rise to congenital malformation and it appears that the GBP exposure during the organogenesis period proliferatively affects the total number of neurons.
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