Valproic acid and its salt, sodium valproate, are an effective treatment for epilepsy, the most common chronic neurologic disorder worldwide. Teratogenic associations reported after embryofetal exposure has limited the recommendations of valproate use in women of childbearing age, after careful evaluation of the benefits and risks of this medication. The mechanisms of valproate damage during pregnancy are complex and incompletely clarified up to date. Maternal and fetal impact of valproate is a critical issue, standing at the base of the new consensus on practical guidelines for clinical use of antiepileptic treatment in fertile women.
Epilepsy is characterized by recurrent seizures that cannot be associated with other specific causes. The presence of a single convulsive or tonic seizure after a stroke does not necessarily mean that a person develops a form of epilepsy unless the convulsions become chronic and recurrent poststroke epilepsy. The purpose of our study is to highlight the existence of a connection between the type and the topography of a vascular stroke on the one hand, and on the other hand, the type of seizures that have occurred and how long they have occurred after the stroke. The study was conducted in a total of 165 patients at the Prof. Dr. Nicolae Oblu Emergency Clinical Hospital, Iaşi, Romania, diagnosed with stroke and spastic seizures after stroke and who survived for at least one year. In this study, the ideal patient should be the patient diagnosed for the first time with temporal lobe epilepsy, followed longitudinally by high-resolution imaging techniques. Studying topography and morphopathology of poststroke sequelae can lead to an increase in accuracy prediction of epilepsy after it.
In order to increase the quality of life of patients with epilepsy, it is essential to develop tools that facilitate early disease diagnosis and encourage the use of individualized therapies. The association between seizures and other neurological pathologies is well known but incompletely explained, with multiple sclerosis (MS)-seizures correlation being a relevant example. In this context, the present review aimed to highlight the most important facts related to the association between the heterogeneous group of epileptic pathology and MS, in order to provide initial directions for establishing a diagnostic and therapeutic protocol. The first part reviewed the most relevant epidemiological and clinical data on seizures; MS association. Subsequently, it highlighted the most common and actually accepted pathophysiological mechanisms that try to explain the association between the two pathologies. Finally, the importance of paraclinical investigations and the optimal choice of antiseizure-based therapies with respect to seizures associated with MS are presented, also revealing several directions that should be explored in the near future. Contents 1. Introduction 2. Methodology and method 3. Epidemiological data revealing a significant association between MS and seizures 4. Relevant aspects of seizures in patients with MS 5. Pathophysiological mechanisms (incompletely) explaining the MS-epilepsy association 6. The role of imagistic techniques in studying the MS-epilepsy association 7. Neurophysiology in patients with MS with epilepsy-in search of specific patterns 8. Individualized ASMs treatment and prognosis in patients with MS with epilepsy 9. Conclusions
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