levetiracetam and Venous-Thrombosis

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 2.2kg. 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.

Topics: Acetamides; Adult; Anticonvulsants; Female; Fetal Blood; Humans; Infant, Newborn; Lacosamide; Levetiracetam; Male; Milk, Human; Piracetam; Pregnancy; Status Epilepticus; Venous Thrombosis

Cerebral venous thrombosis is a rare entity in pregnancy and the postpartum period, with an incidence of 1:10,000 to 1:25,000.. A 19-year-old woman, gravida 1, para 1, presented to the emergency department on postpartum day 7, having experienced seizures. Severe preeclampsia had been diagnosed during the antepartum period. The patient initially was diagnosed with postpartum eclampsia and started on magnesium sulfate for seizure prophylaxis. Magnetic resonance imaging later showed cerebral venous thrombosis of the left transverse sinus and right frontal and left frontoparietal cortical veins.. Cerebral venous thrombosis and eclampsia may manifest in a similar manner. Physicians can optimize the care of patients presenting with seizures by considering etiologies rarer than eclampsia and pursuing tests that may distinguish them.

Topics: Anticoagulants; Anticonvulsants; Brain; Female; Heparin; Humans; Hypertension; Levetiracetam; Magnesium Sulfate; Magnetic Resonance Imaging; Piracetam; Postpartum Period; Pregnancy; Pregnancy Complications, Hematologic; Seizures; Sinus Thrombosis, Intracranial; Stroke; Tomography, X-Ray Computed; Treatment Outcome; Venous Thrombosis; Young Adult