Liu Chen, Pace Samuel, Bromley Rebecca, Dobson Ruth
Preventive Neurology Unit, Wolfson Institute of Population Health, QMUL, UK.
Department of Neurology, Royal London Hospital, Barts Health NHS Trust, London, UK.
EClinicalMedicine. 2023 Aug 24;63:102157. doi: 10.1016/j.eclinm.2023.102157. eCollection 2023 Sep.
A range of long-term neurological conditions may be diagnosed in young adulthood. These conditions are generally not curable, and most people need to take ongoing treatment for symptom control and/or disease modification. When chronic diseases are diagnosed before people have completed their families, there is a need to balance the potential benefits of treatment for the mother against potential risk(s) to the fetus from exposure to medications during pregnancy. Whilst available data regarding short-term fetal outcomes following treatment exposures during pregnancy is rapidly increasing, information regarding longer-term outcomes is more limited. The association of fetal exposure to valproate with serious long-term neurodevelopmental outcomes has highlighted the importance of capturing and evaluating long-term data. In this review we examine available evidence around the long-term effects of treatments used for the most common long-term neurological conditions diagnosed in early adulthood, namely epilepsy, migraine and neuroinflammatory disorders. We draw from existing literature across a range of diseases and discuss strategies to improve future knowledge.
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