Neurological Disorders and Pregnancy

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Timely diagnosis and management of neurological diseases during pregnancy poses major therapeutic challenges to neurologists and other non-neurologist health care providers. Pregnancy is a unique period in life associated with significant hormonal and other physiologic changes in female patients, which may trigger or alter the course of neurological and psychiatric disorders. In addition, many diagnostic proceduresthat can be performed in non-pregnant women are prohibited during pregnancy for safety reasons. Therapeutic decisions and management of a pregnant patient with neurological disorders heavily depends on the issue of the reasonable balance between the risks of no treatment versus active treatment for the mother and her fetus.

This book provides a review of the latest findings in this field,giving the neurologist and non-neurologist the information they need to determine the best treatment. Neurological disorders covered include multiple sclerosis, stroke and epilepsy.

  • Discusses how neurological disorders shouldbemanagedin a pregnant patient
  • Includes contributions from leading authorities
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Product Details

  • ISBN-13: 9780123849113
  • Publisher: Elsevier Science
  • Publication date: 12/23/2010
  • Pages: 218
  • Product dimensions: 6.00 (w) x 9.10 (h) x 0.90 (d)

Table of Contents

Preface ix

Contributors xi

1 Pregnancy and Multiple Sclerosis Laura Airas Masoud Etemadifar Amir-Hadi Maghzi 1

Introduction 1

How Pregnancy Affects the Disease Activity 2

Pregnancy Outcome Among MS Mothers 3

Treatment of MS Mothers During Pregnancy and Lactation 4

Immunologic Basis of Pregnancy-Induced Disease Remission 6

Conclusion 8

2 Headache in Pregnancy Debra Elliott Xiangping Li Peimin Zhu Emil Gaitour 13

Introduction 13

Epidemiology of Headache in Pregnancy 13

Pathophysiology of Primary Headache During Pregnancy 18

Management of Primary Headache in Pregnancy 22

Pharmacologic Treatments 25

Secondary Headaches and Their Management 32

Conclusion 44

3 Myasthenia Gravis and Pregnancy Fernanda Campos da Silva Luciana Carneiro do Cima Renato Augusto Moreira de Sá 55

Introduction 55

Clinical Features 55

Diagnosis 56

General Aspects of Preconception Care 57

Effect of Preganancy on MG 57

Effect of MG in Pregnancy 58

Treatment 60

Labor and Delivery 63

Effects on the Fetus and Neonate 65

4 Postpartum Angiopathy and Related Disorders Jennifer E. Fugate Alejandro A. Rabinstein 69

Background and Context 69

Postpartum Angiopathy 69

5 Neurology of Pre-eclampsia and Eclampsia Roger E. Kelley Maike Tiede Blaya Patricia Colon 79

Pathophysiology 79

Neurologic Manifestations of Pre-eclampsia/Eclampsia 80

Cerebrovascular Disease 82

Epilepsy 85

Neurobehavioral Aspects of Pre-eclampsia/Eclampsia 87

6 Epilepsy and Pregnancy John W. Kevill Eduardo Gonzalez-Toledo 91

Introduction 91

History 92

Fertility and Epilepsy 94

Contraception and Epilepsy 96

The Effect of Pregnancy on Epilepsy 97

The Effects of Epilepsy on Pregnancy 100

Eclampsia 101

Effects of Maternal Seizures on the Developing Fetus 107

Effects of Epilepsy Treatment on the Developing Fetus 108

Evaluation of a First Seizure in a Pregnant Patient 110

Summary 114

7 Movement Disorders and Pregnancy Natalya Shneyder Aimee Borazanci Aronkumar Reddy Emil Gaitour Alireza Minagar Stephen L. Jaffe 123

Introduction 123

Parkinson's Disease 123

Chorea Gravidarum 125

Huntington's Disease 126

Dystonia 126

Essential Tremor 127

Wilson's Disease 128

Restless Legs Syndrome 129

Tourette's Syndrome 129

Conclusions 130

8 Psychiatric Disorders and Pregnancy Nadejda Alekseeva Rita Horton Felix Geller Jeanie McGee Alireza Minagar 135

Introduction 135

Schizophrenia and Pregnancy 135

Course of Schizophrenia During Pregnancy and Postpartum 137

Antipsychotic Medications and Pregnancy 138

BPD and Pregnancy 143

Postpartum Depression 145

Anxiety Disorders and Pregnancy 147

Eating Disorders and Pregnancy 151

Conclusion 152

9 Neuromuscular Diseases in Pregnancy Kourosh Rezania 159

Pathophysiology 159

Neuromuscular Diseases that Result from Pregnancy, Labor, and the Postpartum Period 161

Muscle Cramps 166

Pregnancy and Underlying Neuromuscular Disease 166

Inflammatory Neuropathies 167

Hereditary Neuropathies 169

Autoimmune Inflammatory Myopathies 170

Hereditary Myopathies 171

Motor Neuron Diseases 175

10 Sleep Disorders and Pregnancy Ahmet Ursavas 185

Regular Sleep Duration and Pattern in Pregnancy 185

Sleep Deprivation in Pregnancy 186

Sleep-Disordered Breathing in Pregnancy 188

Other Sleep Disorders in Pregnancy 197

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