Early pregnancy cerebral venous thrombosis and status epilepticus treated with levetiracetam and lacosamide throughout pregnancy |
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| Institution: | 1. UCSD Division of Medical Toxicology, Department of Emergency Medicine, San Diego, CA;2. California Poison Control System, San Diego, CA;3. UCSD School of Medicine, San Diego, CA;4. UC Davis School of Medicine, Departments of Internal Medicine and Emergency Medicine, Sacramento, CA, USA;1. Department of Neurology, Chang Gung Memorial Hospital, Linkou Branch, No. 5, Fuxing Street, Guishan District, Taoyuan 333, Taiwan;2. Department of Neurology, Xiamen Changgung Hospital, No. 123 Xiafei Road, Haicang District, Xiamen, China;3. Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung Branch, No. 123, Dapi Road, Niaosong District, Kaohsiung 833, Taiwan;4. Department of Neurology, China Medical University Hospital, No. 2, Yude Road, North District, Taichung 404, Taiwan;5. Neurological Institute, Division of Epilepsy, Taichung Veterans General Hospital, No. 1650, Section 4, Taiwan Boulevard, Xitun District, Taichung 407, Taiwan;6. Department of Pediatrics, National Taiwan University Hospital, No. 7, Zhongshan South Road, Zhongzheng District, Taipei 100, Taiwan;7. Department of Neurology, MacKay Memorial Hospital, No. 92, Section 2, Zhongshan North Road, Zhongshan District, Taipei 104, Taiwan;8. UCB Pharma, 14 Taikoo Wan Road, Taikoo, Hong Kong, China;9. UCB Pharma, Alfred-Nobel-Straße 10, 40789 Monheim am Rhein, Germany;10. UCB Pharma, 8010 Arco Corporate Drive, Raleigh, NC 27617, USA;11. UCB Pharma, 12th Floor-2, No.88, Dunhua North Road, Songshan District, Taipei 10551, Taiwan;1. Children''s Hospital, University of Helsinki and Helsinki University Hospital, Finland;2. Department of Children''s Clinical Neurophysiology, HUS Medical Imaging Center and Children''s Hospital, Helsinki University Hospital and University of Helsinki, Finland;3. Clinical Neurosciences, Neurology, University of Helsinki and Hyvinkää Hospital, Helsinki and Uusimaa Hospital District, Finland;4. Clinical Neurosciences, Head and Neck Center, Neuropsychology, University of Helsinki and Helsinki University Hospital, Finland;5. Infant Cognition Laboratory, Center for Child Health Research, School of Medicine, University of Tampere, Finland;1. Stanford University, United States;2. Brigham & Women''s Hospital, Harvard Medical School, United States;3. The Emmes Corporation, United States;4. Northwestern University, United States;5. University of Southern California, United States;6. Emory University, United States;7. Minnesota Epilepsy Group, United States;8. University of Cincinnati, United States;9. New York University, United States;10. Northwell Health, United States;11. Columbia University, United States;12. Wake Forest University, United States |
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| Abstract: | Cerebral venous thrombosis (CVT) is an uncommon cause of stroke, accounting to less than 1% of all strokes.We describe a pregnant woman with a massive CVT in early pregnancy, complicated by status epilepticus. The mother was treated with levetiracetam, lacosamide, and enoxaparin throughout pregnancy. A male infant was born on pregnancy week 36, weighing 2.2 kg. Both levetiracetam and and lacosamide were present in cord blood in levels similar to those in maternal blood. The infant was partially breast-fed and experienced poor feeding and sleepiness, starting to resolve after two first weeks. Milk samples were drawn 5 days after the delivery and a blood sample from the infant 3 days later.Lacosamide level in milk was low, resulting in an estimated relative infant dose of 1.8% of the maternal weight-adjusted daily dose in a fully breast-fed infant. This is the first case describing lacosamide use during pregnancy and lactation. |
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| Keywords: | Lacosamide Pregnancy Lactation Cerebral venous thrombosis Status epilepticus |
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