Differences in treatment of epilepsy in pregnancy
A worldwide survey
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Abstract
Background How to safely treat pregnant women with epilepsy is a question for which there are guidelines, but variations in practice exist.
Methods To better characterize how clinicians address this difficult clinical question, we distributed an anonymous survey to neurology practitioners across subspecialties and different levels of training via the Neurology®: Clinical Practice website. The survey was conducted from May 31 to December 3, 2017. We received responses from 642 participants representing 81 countries. We performed both descriptive and inferential analyses. For the inferential analysis, a multiple logistic regression model was used to analyze the effect of provider characteristics on the constructed binary outcome variables of interest.
Results The results of this survey demonstrate a wide range in the amount of folic acid recommended and the frequency of checking levels of anti-epileptic drugs. Choice of first-line agent varied by the economic development status of the respondent's country, suggesting that access to medications plays an important role in clinical decision making in many parts of the world.
Conclusion This survey highlights several areas where further research would be helpful in guiding practice.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
Explore this topic: NPub.org/NCP/pc5
Interactive world map: NPub.org/NCP/map05
More Practice Current: NPub.org/NCP/practicecurrent
- Received September 25, 2018.
- Accepted January 17, 2019.
- © 2019 American Academy of Neurology
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The Nerve!: Rapid online correspondence
- Reader Response: Differences in treatment of epilepsy in pregnancy: a worldwide survey
- Nitin K. Sethi, Associate Professor of Neurology, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY (U.S.A.)
Submitted July 04, 2019
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