Nurses may claim up to 2.75 contact hours for this session.
University of Minnesota approves this knowledge-based activity for 2.75 contact hours (0.275 CEUs). UAN JA0000810-9999-19-082-L01-P. Initial Release Date: 12/7/19.
Presidential Symposium: Evidence-Based Treatment for Women with Epilepsy During Reproductive Years: 15 Years of Progress and Future Directions
The reproductive years are a critical time in the lifespan of a female with epilepsy. Treatment choices should be made with consideration of safety during a future potential pregnancy, planned or unplanned. Fortunately, data from animal preclinical studies, pharmacokinetic modeling, detailed observational prospective studies, and large-scale pregnancy registries have provided an abundance of findings, permitting evidence-based treatment of women with epilepsy during pregnancy. The goal is to maintain maternal health and seizure control while minimizing fetal risk for adverse outcomes such as major congenital malformations and neurodevelopmental abnormalities. Future directions include enhanced incorporation of pharmacogenomics and genetics into pre-conceptional counseling, with the ability to deliver a personalized medicine approach to each woman with epilepsy during her reproductive years.
Following participation in this activity, participants will be able to:
- Review the latest evidence for differential risks between ASM types and doses for structural teratogenicity
- Discuss how ASMs can affect fetal brain development through studies in animals and humans
- REcognize pharmacokinetic principles during pregnancy and how to adjust ASMs to maintain seizure control
- Review how genetic counseling can be incorporated into clinic for women with epilepsy of childbearing age, now and in the future
Chair: Page Pennell, MD
Introduction, Page Pennell, MD
Decline in MCM Rates as Differential Risks Between ASMs and Doses Have Been Elucidated, Torbjörn Tomson, MD, PhD (Fritz E. Dreifuss Award Winner)
Evidence for Effects of ASMs and Seizures on Fetal Growth and Neurodevelopment: Potential Mechanisms of ASMs on Neurodevelopment from Basic Science, Patrick Forcelli, PhD
Maintaining Seizure Control in Light of Changing Drug Clearance, Page Pennell, MD
More Detailed and Individualized PK Modeling and Potential Role PG Will play in the Future: Possibility of Proactive Empiric Drug Adjustments During Pregnancy, Angela Birnbaum, PhD
Role of Genetics in Caring for WWE: Different Scenarios - Dravet, PVNH, Familial MTLE, JME, Beth Sheidley, MS, CGC
Conclusions, Page Pennell, MD