{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:32:13Z","timestamp":1786422733383,"version":"build-2736575974"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>People with epilepsy of childbearing potential in low-resource settings face unique challenges related to anti-seizure medication (ASM) selection and access. These challenges may be particularly pronounced in regions where neurocysticercosis (NCC), a leading cause of acquired epilepsy worldwide, contributes substantially to the burden of disease. We characterized ASM prescribing patterns and factors associated with the use of higher-risk medications among people with epilepsy of childbearing potential in northern Peru.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from females aged 15\u201349\u202fyears who were enrolled in a prospective, population-based epilepsy cohort in Tumbes, Peru, from 2006 to 2020. ASMs were categorized according to pregnancy-associated safety profiles as Lower-risk (lamotrigine, levetiracetam, oxcarbazepine, clonazepam, diazepam), Intermediate-High risk (carbamazepine, phenytoin, phenobarbital, topiramate), and Highest-risk (valproic acid). We evaluated ASM utilization, polytherapy, and factors associated with valproate use, the highest-risk medication.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1,975 individuals with epilepsy, 685 were of childbearing potential. Approximately one-third met criteria for probable or definite NCC (34.9%). Nearly all participants (98.6%) were prescribed carbamazepine, phenytoin, phenobarbital, or valproic acid, while use of newer-generation agents was rare. Most prescriptions (86.3%) were classified as Intermediate-High-risk, and 12.8% as Highest-risk. In multivariable analyses, prior ASM use and polytherapy were independently associated with receipt of valproate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>In this population-based epilepsy cohort from northern Peru, ASM treatment among people of childbearing potential was overwhelmingly limited to older medications with an elevated risk of teratogenicity. These prescribing patterns likely reflect medication availability rather than clinical preference and highlight the challenges of implementing guideline-recommended epilepsy care in resource-constrained settings. Given the substantial burden of NCC-related epilepsy in this population, improving access to safer and more diverse ASM options may represent an important strategy for reducing treatment inequities among people with epilepsy of childbearing potential.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1916569","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:22:01Z","timestamp":1786422121000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment patterns and access among people with epilepsy of childbearing potential in Peru"],"prefix":"10.3389","volume":"17","author":[{"given":"Samantha E.","family":"Allen","sequence":"first","affiliation":[{"name":"Department of Neurology, University of California, Davis","place":["Davis, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa T.","family":"Wardle","sequence":"additional","affiliation":[{"name":"School of Public Health, Oregon Health and Science University \u2013 Portland State University","place":["Portland, OR, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luz M.","family":"Moyano","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad Nacional de Tumbes","place":["Tumbes, Peru"]},{"name":"Centro de Salud Global, Universidad Peruana Cayetano Heredia","place":["Tumbes, Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Percy","family":"Vilchez","sequence":"additional","affiliation":[{"name":"Centro de Salud Global, Universidad Peruana Cayetano Heredia","place":["Tumbes, Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier A.","family":"Bustos","sequence":"additional","affiliation":[{"name":"Centro de Salud Global, Universidad Peruana Cayetano Heredia","place":["Tumbes, Peru"]},{"name":"Instituto Nacional de Ciencias Neurologicas","place":["Lima, Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector H.","family":"Garcia","sequence":"additional","affiliation":[{"name":"Centro de Salud Global, Universidad Peruana Cayetano Heredia","place":["Tumbes, Peru"]},{"name":"Instituto Nacional de Ciencias Neurologicas","place":["Lima, Peru"]},{"name":"Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia","place":["Lima, Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth E.","family":"O\u2019Neal","sequence":"additional","affiliation":[{"name":"School of Public Health, Oregon Health and Science University \u2013 Portland State University","place":["Portland, OR, United States"]},{"name":"Centro de Salud Global, Universidad Peruana Cayetano Heredia","place":["Tumbes, Peru"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"ref1","volume-title":"Epilepsy: a public Health Imperative","year":"2019"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1016\/S1474-4422(05)70194-0","article-title":"Neurocysticercosis: updated concepts about an old disease","volume":"4","author":"Garcia","year":"2005","journal-title":"Lancet Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1016\/S0140-6736(12)61381-6","article-title":"Epilepsy in poor regions of the world","volume":"380","author":"Newton","year":"2012","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1212\/WNL.0000000000209279","article-title":"Teratogenesis, perinatal, and neurodevelopmental outcomes after in utero exposure to antiseizure medication: practice guideline from the AAN, AES, and 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