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Biomedical subjects

H Klepel

Publications and source records attributed to H Klepel.

At least 19 recordsLinked to original sources
PubMed1997

Maternal use of antiepileptic drugs and the risk of major congenital malformations: a joint European prospective study of human teratogenesis associated with maternal epilepsy.

PURPOSE: To quantify the risks of intrauterine antiepileptic drug (AED) exposure in monotherapy and polytherapy. METHODS: Data from five prospective European studies totaling 1,379 children were pooled and reanalyzed. Data were available for 1,221 children exposed to AED during pregnancy and for 158 children of unexposed control pregnancies. RESULTS: Overall, when comparing a subgroup of 192 children exposed to AED with 158 children of matched nonepileptic controls, there was an increased risk of major congenital malformations (MCA) in children exposed to AED during gestation [relative risk (RR) 2.3; 95% confidence interval (CI): 1.2-4.7]. A significant increase in risk was found for children exposed to valproate (VPA) (RR 4.9; 95% CI: 1.6-15.0) or carbamazepine (CBZ) (RR 4.9; 95% CI: 1.3-18.0) in monotherapy. When comparing different AED regimens during all 1,221 pregnancies, risks of MCA were significantly increased for the combination of phenobarbital (PB) and ethosuximide (RR 9.8; 95% CI: 1.4-67.3) and the combination of phenytoin, PB, CBZ, and VPA (RR 11.0; 95% CI: 2.1-57.6). Offspring of mothers using > 1,000 mg VPA/day were at a significantly increased risk of MCA, especially neural tube defects, compared to offspring exposed < or =600 mg VPA/day (RR 6.8; 95% CI: 1.4-32.7). No difference in risk of MCA was found between the offspring exposed to 601-1,000 mg/day and < or =600 mg/day. CONCLUSIONS: This reanalysis shows that VPA is consistently associated with an increased risk of MCA in babies born to mothers with epilepsy. Significant associations were also observed with CBZ. Larger prospective population-based studies are needed to evaluate the risks of many other less frequently prescribed treatment regimens, including newly marketed AEDs.

Abnormalities, Drug-Induced↗
PubMed1992

Spina bifida occulta in epilepsy syndromes.

We studied radiographs of the lumbar vertebral column and sacral region for 182 patients with epilepsy for the presence of spina bifida occulta. Spina bifida occulta was twice as common in patients with idiopathic epilepsy as in patients with symptomatic epilepsy and twice as common in patients with idiopathic epilepsy as in the general population. We discuss the relationship between spina bifida occulta and idiopathic epilepsy.

Child↗
PubMed1990

[Relation between spina bifida occulta and various epileptic syndromes].

Radiographs of the lumbar vertebral column and sacral region obtained for 182 epileptic patients after spina bifida occulta were studied. Spina bifida occulta was twice as common in patients with idiopathic epilepsy as in those with symptomatic epilepsy and twice as common as in the normal population. A relationship between spina bifida occulta and idiopathic epilepsy is discussed.

Adolescent↗
PubMed1986

[Comparison of the distribution and toxicity of alpha-, beta-, and gamma-hexachlorocyclohexane (HCH) following 30 days of administration to rats].

Administration of 1000 ppm alpha-HCH, 600 ppm beta-HCH and greater than or equal to 125 ppm gamma-HCH to rats caused a growth retardation. alpha-HCH and beta-HCH led to livermass enlargement. beta-HCH caused a decrease of absolute brain-mass. In case of alpha-HCH and gamma-HCH fat tissue, kidneys and adrenals had a high burden in residues. Fat tissue and adrenals had high residues of beta-HCH. The level of HCH-residues during the test period was gamma much less than beta less than alpha. The results are discussed taking into account the contradictory knowledge from literature.

Animals↗
PubMed1986

[Epilepsy and pregnancy--principles of therapy].

Special aspects of antiepileptic therapy during pregnancy in epileptic women are described. A monotherapy should be preferred. Due to changes in the pharmacokinetics of antiepileptic drugs, plasma level checks must be performed every four weeks during early pregnancy. The possible teratogenetic effects of anticonvulsants and other factors tending to increase of malformation rate are discussed. An explanation is given for the use of prophylactic folic acid and Vitamin K treatment in connection with antiepileptic therapy. The benefits of counselling prior to pregnancy are discussed.

Abnormalities, Drug-Induced↗
PubMed1986

[Prenatal growth of children of epileptic mothers].

In this study 67 children of 59 females with epilepsy and on anticonvulsants were investigated. Children of epileptic women on medication with Primidon are of lower weight and have smaller heads than children from epileptic mothers without medication and children from parents without epilepsy.

Anticonvulsants↗
PubMed1986

[Possible uses of Convulsofin liquid in the treatment of pediatric epilepsies].

The effect of Convulsofin-liquidum on several epilepsies and types of seizure in childhood is described. Typical and atypical absences, tonic-clonic seizures of primary generalised epilepsies as well as atonic or myoclonic seizures are considered to be the main indications for the treatment with Convulsofin. To the special advantage of the application in drops especially with infants is referred.

Administration, Oral↗
PubMed1985

[Results of catamnestic studies on the social prognosis of childhood epilepsies].

Owing to the progress in pharmakotherapy the individual prognosis of epilepsy is characterized above all by brainorganic or psychoreactive caused disorders of the adaptability. The results of the examination of 153 children are presented, which were stationary treated for epilepsy. The special problems in the family, the school and in the choice of a job are referred.

Adolescent↗
PubMed1985

[Value of various social and biological risk factors in child development].

The medical reports of 400 children stationarilly treated for several symptoms and syndromes of abnormal behavior were evaluated. Especially important social factors are the in complete family and disorders of the parent-child-relations as well as the insufficient over-coming of educational problems. Children with results from infantile brain damage are especially endangered by a failure of compensation.

Adolescent↗
PubMed1984

[Epilepsy and pregnancy--results of interdisciplinary cooperation].

A total of 19 female epileptics were jointly counselled, cared for and delivered during 21 pregnancies. Special aspects that must be taken into account during pregnancy in epileptics are described. Due to changes in the pharmacokinetics of anti-epileptic drugs, plasma level checks must be performed every four weeks during early pregnancy. The possible teratogenic effects of anticonvulsants and other factors tending to increase the malformation rate are discussed. An explanation is given for the use of prophylactic folic acid and vitamin k treatment in connection with anti-epileptic therapy. Breast feeding has not only proved advantageous from the nutritional standpoint but also helps withdraw the new-born, who is habituated to anticonvulsants, from the drugs without negative symptoms. The benefits of counselling prior to pregnancy and general questions relating to women who are prone to seizures while they are of child-bearing age is discussed.

Adolescent↗
PubMed1983

[Clinical, electroencephalographic and computer tomographic studies of children with West and Lennox-Gastaut syndrome].

The results of clinical, electroencephalographic and repeated computed tomographic examination of 14 children suffering from epileptic seizures in connection with the West and Lennox-Gastaud syndrome are analyzed and compared. Computed tomography yields little information regarding the etiology of such forms of epilepsy. Distinct clinical and electroencephalographic findings were accompanied by normal computed tomographic results in a large proportion of the cases. To avoid misinterpretation of computed tomographic findings and consequent prognostic errors in these epileptic cases it is necessary to take possible side effects of ACTH and corticosteroid treatment into account. At the climax of hormone treatment computed tomography revealed imposing changes in the form of generalized atrophy in 10 of the 14 children examined. These receded completely upon termination of hormone treatment.

Adrenocorticotropic Hormone↗