Special Considerations in the Management of Women with Epilepsy in Reproductive Years

Krishna Parekh; Hannah Debra Kravets; Rebecca Spiegel

doi:10.3390/jpm12010088

Special Considerations in the Management of Women with Epilepsy in Reproductive Years

Krishna Parekh
, Hannah Debra Kravets
, Rebecca Spiegel

Neurology

Stony Brook University

Research output: Contribution to journal › Review article › peer-review

9 Scopus citations

Abstract

Anti-seizure medications (ASMs) fail to prevent seizure recurrence in more than 30% of patients with epilepsy. The treatment is more difficult in premenopausal women with epilepsy (WWE) because changes in plasma estrogen and progesterone concentrations during the menstrual cycle often affect seizure frequency and intensity. Interactions between enzyme-inducin ASMs and hormonal contraceptives can lead to both a loss of seizure control and failure of contraception. Significant changes in the function of the liver and kidneys during pregnancy can accelerate metabolism and elimination of ASMs, causing breakthrough seizures. In addition, the teratogenic, cognitive, and psychological effects of ASMs on potential offspring have to be considered when choosing the best ASM regimen. Therefore, aspecialized approach is necessary for the treatment of premenopausal WWE.

Original language	English
Article number	88
Journal	Journal of Personalized Medicine
Volume	12
Issue number	1
DOIs	https://doi.org/10.3390/jpm12010088
State	Published - Jan 2022

Keywords

Catamenial seizures
Hormonal changes
Hormonal contraceptives
Women with epilepsy

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10.3390/jpm12010088

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title = "Special Considerations in the Management of Women with Epilepsy in Reproductive Years",

abstract = "Anti-seizure medications (ASMs) fail to prevent seizure recurrence in more than 30\% of patients with epilepsy. The treatment is more difficult in premenopausal women with epilepsy (WWE) because changes in plasma estrogen and progesterone concentrations during the menstrual cycle often affect seizure frequency and intensity. Interactions between enzyme-inducin ASMs and hormonal contraceptives can lead to both a loss of seizure control and failure of contraception. Significant changes in the function of the liver and kidneys during pregnancy can accelerate metabolism and elimination of ASMs, causing breakthrough seizures. In addition, the teratogenic, cognitive, and psychological effects of ASMs on potential offspring have to be considered when choosing the best ASM regimen. Therefore, aspecialized approach is necessary for the treatment of premenopausal WWE.",

keywords = "Catamenial seizures, Hormonal changes, Hormonal contraceptives, Women with epilepsy",

author = "Krishna Parekh and Kravets, \{Hannah Debra\} and Rebecca Spiegel",

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T1 - Special Considerations in the Management of Women with Epilepsy in Reproductive Years

AU - Parekh, Krishna

AU - Kravets, Hannah Debra

AU - Spiegel, Rebecca

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Y1 - 2022/1

N2 - Anti-seizure medications (ASMs) fail to prevent seizure recurrence in more than 30% of patients with epilepsy. The treatment is more difficult in premenopausal women with epilepsy (WWE) because changes in plasma estrogen and progesterone concentrations during the menstrual cycle often affect seizure frequency and intensity. Interactions between enzyme-inducin ASMs and hormonal contraceptives can lead to both a loss of seizure control and failure of contraception. Significant changes in the function of the liver and kidneys during pregnancy can accelerate metabolism and elimination of ASMs, causing breakthrough seizures. In addition, the teratogenic, cognitive, and psychological effects of ASMs on potential offspring have to be considered when choosing the best ASM regimen. Therefore, aspecialized approach is necessary for the treatment of premenopausal WWE.

AB - Anti-seizure medications (ASMs) fail to prevent seizure recurrence in more than 30% of patients with epilepsy. The treatment is more difficult in premenopausal women with epilepsy (WWE) because changes in plasma estrogen and progesterone concentrations during the menstrual cycle often affect seizure frequency and intensity. Interactions between enzyme-inducin ASMs and hormonal contraceptives can lead to both a loss of seizure control and failure of contraception. Significant changes in the function of the liver and kidneys during pregnancy can accelerate metabolism and elimination of ASMs, causing breakthrough seizures. In addition, the teratogenic, cognitive, and psychological effects of ASMs on potential offspring have to be considered when choosing the best ASM regimen. Therefore, aspecialized approach is necessary for the treatment of premenopausal WWE.

KW - Catamenial seizures

KW - Hormonal changes

KW - Hormonal contraceptives

KW - Women with epilepsy

UR - https://www.scopus.com/pages/publications/85123164212

U2 - 10.3390/jpm12010088

DO - 10.3390/jpm12010088

M3 - Review article

AN - SCOPUS:85123164212

SN - 2075-4426

VL - 12

JO - Journal of Personalized Medicine

JF - Journal of Personalized Medicine

IS - 1

M1 - 88

ER -

Special Considerations in the Management of Women with Epilepsy in Reproductive Years

Abstract

Keywords

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