Confusional state in a pregnant woman: A case of NMDA receptor encephalitis during pregnancy

Grewal, Kirat Singh; Bhatia, Rohit; Singh, Nishita; Singh, Rajesh; Dash, Deepa; Tripathi, Manjari

doi:10.1016/j.jneuroim.2018.10.008

Cited by 9 publications

(5 citation statements)

References 16 publications

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“…Around 20 other cases were reported nonsystematically in the literature. [69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85] Their analysis largely confirms these findings, although up to one-third had complicated pregnancies or spontaneous miscarriages, most likely due to intensive care treatment, epileptic seizures and autonomous dysfunction of the mothers. There is a report on one child with developmental delay and epilepsy due to cortical dysplasia, born to a mother with anti-NMDA receptor encephalitis starting at gestational week 7, who later died from septic shock.…”

Section: Epidemiology Focusing On Gender Aspects Anti-n-methyl-d-aspartate Receptor Encephalitismentioning

confidence: 92%

Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG)

Altıntaş

Dargvainiene

Schneider‐Gold

et al. 2020

Ther Adv Neurol Disord

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Neuromyelitis optica spectrum disorder (NMOSD), autoimmune encephalitis (AE), myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) are antibody-mediated neurological diseases. They have mostly female predominance, affecting many women during childbearing age. Interactions between the underlying disease (or necessary treatment) and pregnancy can occur in every of these illnesses. Herein, we present the characteristics of NMOSD, AE, MG and LEMS in general, and review published data regarding the influence of the different diseases on fertility, pregnancy, puerperium, treatment strategy during pregnancy and post-partum period, and menopause but also male factors. We summarise key elements that should be borne in mind when confronted with such cases.

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Section: Epidemiology Focusing On Gender Aspects Anti-n-methyl-d-aspartate Receptor Encephalitismentioning

confidence: 92%

Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG)

Altıntaş

Dargvainiene

Schneider‐Gold

et al. 2020

Ther Adv Neurol Disord

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“…The majority of publications included in this review were the 14 case reports for lacosamide. 18–31 The other publications on lacosamide included nine case series, 32–40 one retrospective cohort study, 41 and two pharmacovigilance safety reports. 42,43…”

Section: Resultsmentioning

confidence: 99%

“…The majority of publications included in this review were the 14 case reports for lacosamide. [18][19][20][21][22][23][24][25][26][27][28][29][30][31] The other publications on lacosamide included nine case series, [32][33][34][35][36][37][38][39][40] one retrospective cohort study, 41 and two pharmacovigilance safety reports. 42,43 Ben-Menachem et al reported in a multicenter open-label trial that two individuals became pregnant.…”

Section: Synthesis Of Results From Included Studiesmentioning

confidence: 99%

Third generation antiseizure medications exposure during pregnancy and neonatal adverse birth outcomes: A systematic review

Goubran,

Okunnu,

Lavu

et al. 2024

Science Progress

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Background: Third generation antiseizure medications (ASMs) are currently used for seizure control as well as several other indications, including pain management and psychiatric disorders. As a result, maternal exposure to third generation ASMs during pregnancy has become increasingly prevalent. The current systematic review aimed to summarize the published evidence on third generation ASMs and their effect on preterm birth, cesarean section (c-section) and fetal loss. Methods: The following databases were searched: Medline, Embase, International Pharmaceutical Abstracts, Cochrane Library and Scopus until September 2022. Results: We screened 2987 studies, and identified 32 studies or case reports for inclusion, however only one study utilized a control group. Narrative systematic evidence synthesis was conducted for brivaracetam, eslicarbazepine, fosphenytoin, lacosamide and perampanel. Conclusion: Due to the scarcity and quality of published studies, drawing clear-cut conclusions regarding third generation ASMs and the outcomes of interest is challenging. More comparative safety studies focusing on neonatal safety of third generation ASMs in pregnancy are essential.

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“…According to Newcastle–Ottawa Quality Assessment Scale (NOS), 16 articles received a score of 5, 19 articles had a score of 4, and 5 articles were scored 3 (score results in detail are shown in Table S4). Details of the included articles are reported in Table 1 7,12–51 …”

Section: Resultsmentioning

confidence: 99%

Autoimmune encephalitis during pregnancy: A diagnostic and therapeutic challenge—A systematic review with individual patients' analysis and clinical recommendations

et al. 2023

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SUMMARYSeveral reports have described the autoimmune encephalitis’ (AE) possible onset during pregnancy. In this systematic review, we summarize the available data on the diagnostic and therapeutic approach to AE during pregnancy, highlighting the associated maternal and fetal clinical outcomes. A systematic search of the literature was performed. The following databases were used: Pubmed, Google Scholar, EMBASE, CrossRef. The revision was registered on the PROSPERO platform (CRD42022336357). Forty‐nine patients were included. AE onset was mainly observed during the first and the second trimester of pregnancy with psychiatric manifestations and seizures as main onset symptoms. CSF analysis showed AE‐specific autoantibody positivity in 33 patients (anti‐NMDA receptor as the most frequent). EEG generally showed normal findings. MRI revealed pathological findings in less than half of patients. Tumor screening was positive findings in 14 cases. First line immunotherapy (single or combined) was generally employed while second line was administered in a minority of patients. Levetiracetam was the most used antiseizure medication. Cesarean section was performed in 18 women. Most of the women had an excellent early outcome after delivery but 22 showed persistent neurological deficits in long‐term follow‐up. Fetal outcome was positive in 33 cases whereas 12 cases of fetal death were reported. A logistic regression showed that no variable significantly influenced the odds of good/bad maternal and fetal clinical outcome. Diagnosis and treatment of AE during pregnancy is challenging. The rate of miscarriage in women with AE seems to be higher than the general population. In addition, mothers may show long‐term neurological deficits.

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Confusional state in a pregnant woman: A case of NMDA receptor encephalitis during pregnancy

Cited by 9 publications

References 16 publications

Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG)

Gender issues of antibody-mediated diseases in neurology: (NMOSD/autoimmune encephalitis/MG)

Third generation antiseizure medications exposure during pregnancy and neonatal adverse birth outcomes: A systematic review

Autoimmune encephalitis during pregnancy: A diagnostic and therapeutic challenge—A systematic review with individual patients' analysis and clinical recommendations

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