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EPILEPSIA Y EMBARAZO, NUEVAS APORTACIONES EN UN AREA DE TRABAJO INTERDISCIPLINARIA ENTRE NEUROLOGOS Y GINECOLOGOS

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EPILEPSIA Y EMBARAZO, NUEVAS APORTACIONES EN UN AREA DE TRABAJO INTERDISCIPLINARIA ENTRE NEUROLOGOS Y GINECOLOGOS

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Se destaca la importancia de las nuevas terapéuticas para la embarazada epiléptica, no sólo en el manejo de la enfermedad en diferentes situaciones clínicas sino por los buenos resultados que se han observado con el empleo de lamotrigina.
dsalgado.jpg Autor:
Manuel Domínguez Salgado
Columnista Experto de SIIC
Artículos publicados por Manuel Domínguez Salgado
Coautores
Rocío Santiago Gómez* María del Carmen Díaz-Obregón Santos* Hari Bhathal** 
Dra., Hospital Clinico San Carlos*
Dr., Hospital Clinico San Carlos**
Recepción del artículo
28 de Abril, 2003 		Primera edición
23 de Julio, 2003 		Segunda edición, ampliada y corregida
7 de Junio, 2021

EPILEPSIA Y EMBARAZO, NUEVAS APORTACIONES EN UN AREA DE TRABAJO INTERDISCIPLINARIA ENTRE NEUROLOGOS Y GINECOLOGOS

Resumen
Introducción. El tratamiento de la paciente con epilepsia durante la gestación constituye un importante dilema clínico. Por un lado hay que mantenerla libre de crisis y por otra, procurar mantenerla en monoterapia y con la menor dosis posible, por los efectos del tratamiento sobre la descendencia. Desarrollo. Existe un síndrome relacionado con la exposición intraútero a fármacos epilépticos clásicos, el cual no puede ser asociado a un determinado fármaco. Todavía hay una gran incógnita sobre los efectos de los nuevos antiepilépticos sobre la descendencia, pero hasta la fecha no se ha descrito ningún patrón de malformaciones específico para ninguno de tales medicamentos. De éstos, la lamotrigina es aquel del que se tiene experiencia clínica más amplia, y aunque el número de casos registrados hasta la actualidad es insuficiente para obtener conclusiones definitivas, no se ha observado mayor incidencia de anomalías congénitas en comparación con la población normal. Conclusiones. Los nuevos fármacos antiepilépticos presentan importante ventaja terapéutica, no sólo en el manejo de la epilepsia en diferentes situaciones clínicas sino por los buenos resultados que se han observado con el empleo de lamotrigina en la paciente epiléptica en edad reproductiva.

Palabras clave
Embarazo, epilepsia, feto, fármacos antiepilépticos, lamotrigina


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Abstract
Introduction. Treatment of the epileptic patient during pregnancy poses a major clinical dilemma. For one thing the patient has to be kept free of seizures, but she also should be kept on monotherapy at the lowest possible dose, due to the effect such medication may have on the unborn child. Development. There is a syndrome related to intrauterine exposure to the classical antiepileptic drugs, but which is not associated with any particular drug. However, the effect of the new antiepileptic drugs on unborn children is still unknown. To date, no specific pattern of malformations has been described in relation to any of these drugs. Lamotrigine is the one with which there is most clinical experience. Although there are still not enough cases studied to permit definite conclusions to be drawn, at the moment the incidence of congenital anomalies is the same as in the general population. Conclusions. The new antiepileptic drugs have a major therapeutic advantage, not only in the management of epilepsy in different clinical situations, but also in the good results observed when using lamotrigine in patients of fertile age.

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Especialidades
Principal: Neurología
Relacionadas: Farmacología, Medicina Familiar, Medicina Interna, Obstetricia y Ginecología



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