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Women with Epilepsy

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Absolute Epilepsy and EEG Rotation Review

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Abstract

Women with epilepsy experience many challenges throughout their life span starting from puberty to menopause and beyond. These include worsening of their seizure frequency and intensity at certain times of their menstrual period secondary to hormonal fluctuations known as catamenial epilepsy. Women with epilepsy may have fear of pregnancy and harmful effect of seizure medications on their babies. They have legitimate concerns regarding the effects of seizures and seizure medications on their body, their sex life, and their fertility. There are worries regarding contraception failure due to seizure medications, and long term medication effects such as osteoporosis. This chapter is meant to highlight recognition and treatment of catamenial epilepsy, perinatal counseling and overall care of women with epilepsy in every stage of their lives.

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References

  1. Backstrom T. Epileptic seizures in women related to plasma estrogen and progesterone during the menstrual cycle. Acta Neurol Scand. 1976;54(4):321–47.

    Article  CAS  PubMed  Google Scholar 

  2. Laidlaw J. Catamenial epilepsy. Lancet. 1956;271(6955):1235–7.

    Article  CAS  PubMed  Google Scholar 

  3. Locock C. Discussion. In: Sieveking EH (ed) Analysis of fifty-two cases of epilepsy observed by the author. Med Times Gaz. 1857;14:524–6.

    Google Scholar 

  4. Herzog AG, Klein P, Ransil BJ. Three patterns of catamenial epilepsy. Epilepsia. 1997;38(10):1082–8.

    Article  CAS  PubMed  Google Scholar 

  5. Herzog AG. Catamenial epilepsy: definition, prevalence pathophysiology and treatment. Seizure. 2008;17(2):151–9.

    Article  PubMed  Google Scholar 

  6. Rudick CN, Woolley CS. Estrogen regulates functional inhibition of hippocampal CA1 pyramidal cells in the adult female rat. J Neurosci. 2001;21(17):6532–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Reddy DS. Pharmacology of endogenous neuroactive steroids. Crit Rev Neurobiol. 2003;15(3–4):197–234.

    CAS  PubMed  Google Scholar 

  8. Herzog AG, et al. Contraceptive practices of women with epilepsy: findings of the epilepsy birth control registry. Epilepsia. 2016;57(4):630–7.

    Article  PubMed  Google Scholar 

  9. Reddy DS, Kim HY, Rogawski MA. Neurosteroid withdrawal model of perimenstrual catamenial epilepsy. Epilepsia. 2001;42(3):328–36.

    Article  CAS  PubMed  Google Scholar 

  10. Younus I, Reddy DS. Seizure facilitating activity of the oral contraceptive ethinyl estradiol. Epilepsy Res. 2016;121:29–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Herzog AG, et al. Interictal EEG discharges, reproductive hormones, and menstrual disorders in epilepsy. Ann Neurol. 2003;54(5):625–37.

    Article  PubMed  Google Scholar 

  12. Herzog AG. Disorders of reproduction in patients with epilepsy: primary neurological mechanisms. Seizure. 2008;17(2):101–10.

    Article  PubMed  Google Scholar 

  13. Bauer J, Cooper-Mahkorn D. Reproductive dysfunction in women with epilepsy: menstrual cycle abnormalities, fertility, and polycystic ovary syndrome. Int Rev Neurobiol. 2008;83:135–55.

    Article  PubMed  Google Scholar 

  14. Knochenhauer ES, et al. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study. J Clin Endocrinol Metab. 1998;83(9):3078–82.

    CAS  PubMed  Google Scholar 

  15. Isojarvi JI, et al. Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. N Engl J Med. 1993;329(19):1383–8.

    Article  CAS  PubMed  Google Scholar 

  16. Isojarvi JI, Tauboll E, Herzog AG. Effect of antiepileptic drugs on reproductive endocrine function in individuals with epilepsy. CNS Drugs. 2005;19(3):207–23.

    Article  PubMed  Google Scholar 

  17. Svalheim S, et al. Differential effects of levetiracetam, carbamazepine, and lamotrigine on reproductive endocrine function in adults. Epilepsy Behav. 2009;16(2):281–7.

    Article  PubMed  Google Scholar 

  18. Tauboll E, et al. Comparison of reproductive effects of levetiracetam and valproate studied in prepubertal porcine ovarian follicular cells. Epilepsia. 2006;47(9):1580–3.

    Article  PubMed  Google Scholar 

  19. Herzog AG, et al. Progesterone vs placebo therapy for women with epilepsy: a randomized clinical trial. Neurology. 2012;78(24):1959–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Mattson RH, et al. Treatment of seizures with medroxyprogesterone acetate: preliminary report. Neurology. 1984;34(9):1255–8.

    Article  CAS  PubMed  Google Scholar 

  21. Feely M, Calvert R, Gibson J. Clobazam in catamenial epilepsy. A model for evaluating anticonvulsants. Lancet. 1982;2(8289):71–3.

    Article  CAS  PubMed  Google Scholar 

  22. Feely M, Gibson J. Intermittent clobazam for catamenial epilepsy: tolerance avoided. J Neurol Neurosurg Psychiatry. 1984;47(12):1279–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Coulam CB, Annegers JF. Do anticonvulsants reduce the efficacy of oral contraceptives? Epilepsia. 1979;20(5):519–25.

    Article  CAS  PubMed  Google Scholar 

  24. Fairgrieve SD, et al. Population based, prospective study of the care of women with epilepsy in pregnancy. BMJ. 2000;321(7262):674–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Johnston CA, Crawford PM. Anti-epileptic drugs and hormonal treatments. Curr Treat Options Neurol. 2014;16(5):288.

    Article  PubMed  Google Scholar 

  26. Lazorwitz A, et al. The effect of carbamazepine on etonogestrel concentrations in contraceptive implant users. Contraception. 2017;95(6):571–7.

    Article  CAS  PubMed  Google Scholar 

  27. Haukkamaa M. Contraception by Norplant subdermal capsules is not reliable in epileptic patients on anticonvulsant treatment. Contraception. 1986;33(6):559–65.

    Article  CAS  PubMed  Google Scholar 

  28. Vajda FJE, et al. Predicting epileptic seizure control during pregnancy. Epilepsy Behav. 2018;78:91–5.

    Article  PubMed  Google Scholar 

  29. Cagnetti C, et al. Seizure course during pregnancy in catamenial epilepsy. Neurology. 2014;83(4):339–44.

    Article  PubMed  Google Scholar 

  30. Pennell PB, et al. Lamotrigine in pregnancy: clearance, therapeutic drug monitoring, and seizure frequency. Neurology. 2008;70(22 Pt 2):2130–6.

    Article  CAS  PubMed  Google Scholar 

  31. Reimers A, et al. Zonisamide serum concentrations during pregnancy. Epilepsy Res. 2018;144:25–9.

    Article  CAS  PubMed  Google Scholar 

  32. Petrenaite V, Sabers A, Hansen-Schwartz J. Seizure deterioration in women treated with oxcarbazepine during pregnancy. Epilepsy Res. 2009;84(2–3):245–9.

    Article  CAS  PubMed  Google Scholar 

  33. Christensen J, Sabers A, Sidenius P. Oxcarbazepine concentrations during pregnancy: a retrospective study in patients with epilepsy. Neurology. 2006;67(8):1497–9.

    Article  CAS  PubMed  Google Scholar 

  34. Harden CL, et al. Practice parameter update: management issues for women with epilepsy--focus on pregnancy (an evidence-based review): obstetrical complications and change in seizure frequency: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology. 2009;73(2):126–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Chen YH, et al. Affect of seizures during gestation on pregnancy outcomes in women with epilepsy. Arch Neurol. 2009;66(8):979–84.

    Article  PubMed  Google Scholar 

  36. Adab N, et al. The longer term outcome of children born to mothers with epilepsy. J Neurol Neurosurg Psychiatry. 2004;75(11):1575–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Shorvon SD, Tomson T, Cock HR. The management of epilepsy during pregnancy--progress is painfully slow. Epilepsia. 2009;50(5):973–4.

    Article  PubMed  Google Scholar 

  38. Hernandez-Diaz S, et al. Fetal growth and premature delivery in pregnant women on antiepileptic drugs. Ann Neurol. 2017;82(3):457–65.

    Article  CAS  PubMed  Google Scholar 

  39. Tomson T, et al. Antiepileptic drugs and intrauterine death: a prospective observational study from EURAP. Neurology. 2015;85(7):580–8.

    Article  CAS  PubMed  Google Scholar 

  40. Meador KJ, et al. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr. 2014;168(8):729–36.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Meador KJ, et al. Cognitive function at 3 years of age after fetal exposure to antiepileptic drugs. N Engl J Med. 2009;360(16):1597–605.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Deshmukh U, et al. Behavioral outcomes in children exposed prenatally to lamotrigine, valproate, or carbamazepine. Neurotoxicol Teratol. 2016;54:5–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Levine SZ, et al. Association of maternal use of folic acid and multivitamin supplements in the periods before and during pregnancy with the risk of autism spectrum disorder in offspring. JAMA Psychiat. 2018;75:176–84.

    Article  Google Scholar 

  44. Gao Y, et al. New perspective on impact of folic acid supplementation during pregnancy on neurodevelopment/autism in the offspring children – a systematic review. PLoS One. 2016;11(11):e0165626.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Harden CL, et al. Practice parameter update: management issues for women with epilepsy--focus on pregnancy (an evidence-based review): teratogenesis and perinatal outcomes: report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology. 2009;73(2):133–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Wald NJ, et al. Blood folic acid and vitamin B12 in relation to neural tube defects. Br J Obstet Gynaecol. 1996;103(4):319–24.

    Article  CAS  PubMed  Google Scholar 

  47. Valera-Gran D, et al. Effect of maternal high dosages of folic acid supplements on neurocognitive development in children at 4-5 y of age: the prospective birth cohort Infancia y Medio Ambiente (INMA) study. Am J Clin Nutr. 2017;106(3):878–87.

    CAS  PubMed  Google Scholar 

  48. Harden CL, et al. The effect of menopause and perimenopause on the course of epilepsy. Epilepsia. 1999;40(10):1402–7.

    Article  CAS  PubMed  Google Scholar 

  49. Pack AM, Walczak TS. Bone health in women with epilepsy: clinical features and potential mechanisms. Int Rev Neurobiol. 2008;83:305–28.

    Article  PubMed  Google Scholar 

  50. Souverein PC, et al. Incidence of fractures among epilepsy patients: a population-based retrospective cohort study in the General Practice Research Database. Epilepsia. 2005;46(2):304–10.

    Article  PubMed  Google Scholar 

  51. Pack AM. Treatment of epilepsy to optimize bone health. Curr Treat Options Neurol. 2011;13(4):346–54.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University of California, Irvine, CA, USA

    Mona Sazgar

  2. Department of Neurology, Riverside, CA, USA

    Michael G. Young

Authors
  1. Mona Sazgar
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  2. Michael G. Young
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Sazgar, M., Young, M.G. (2019). Women with Epilepsy. In: Absolute Epilepsy and EEG Rotation Review. Springer, Cham. https://doi.org/10.1007/978-3-030-03511-2_4

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  • DOI: https://doi.org/10.1007/978-3-030-03511-2_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-03510-5

  • Online ISBN: 978-3-030-03511-2

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