TY - JOUR
T1 - Managing epilepsy in women
AU - Gerard, Elizabeth E.
AU - Meador, Kimford J.
N1 - Funding Information:
Dr Gerard has received honoraria from the American College of Physicians and research support from the National Institute of Neurological Disorders and Stroke and SAGE Pharmaceuticals. Dr Gerard has served as a research consultant on a trial sponsored by UCB, Inc. Dr Meador serves as a consultant for the Epilepsy Study Consortium and on the editorial boards of Epilepsy and Behavior, Journal of Clinical Neurophysiology, and Neurology. Dr Meador has received travel, meeting, and accommodation compensation from UCB, Inc, and receives research support from the National Institute of Neurological Disorders and Stroke and the Patient-Centered Outcomes Research Institute.
Publisher Copyright:
Copyright © American Academy of Neurology.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Purpose of Review: Caring for a woman with epilepsy requires familiarity with the implications of antiepileptic drugs (AEDs) for pregnancy and contraception as well as an understanding of the effects of female hormones on epilepsy. Recent Findings: AED pregnancy registries and prospective studies of cognitive development continue to confirm that valproate poses a significantly increased risk of structural and cognitive teratogenesis. In contrast, data thus far suggest that lamotrigine and levetiracetam are associated with a relatively low risk for both anatomic and developmental adverse effects, although further studies are needed for these and other AEDs. The intrauterine device is a good contraceptive option for many women with epilepsy as it is highly effective and not subject to the drug-drug interactions seen between hormonal contraception and many AEDs. Hormonal-sensitive seizures are common among women with epilepsy; however, highly effective treatments for refractory catamenial seizures are limited. Summary: Women with epilepsy should be counseled early and regularly about reproductive health as it relates to epilepsy. AED selection for women of childbearing age should take future pregnancies and contraceptive needs into consideration.
AB - Purpose of Review: Caring for a woman with epilepsy requires familiarity with the implications of antiepileptic drugs (AEDs) for pregnancy and contraception as well as an understanding of the effects of female hormones on epilepsy. Recent Findings: AED pregnancy registries and prospective studies of cognitive development continue to confirm that valproate poses a significantly increased risk of structural and cognitive teratogenesis. In contrast, data thus far suggest that lamotrigine and levetiracetam are associated with a relatively low risk for both anatomic and developmental adverse effects, although further studies are needed for these and other AEDs. The intrauterine device is a good contraceptive option for many women with epilepsy as it is highly effective and not subject to the drug-drug interactions seen between hormonal contraception and many AEDs. Hormonal-sensitive seizures are common among women with epilepsy; however, highly effective treatments for refractory catamenial seizures are limited. Summary: Women with epilepsy should be counseled early and regularly about reproductive health as it relates to epilepsy. AED selection for women of childbearing age should take future pregnancies and contraceptive needs into consideration.
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U2 - 10.1212/CON.0000000000000270
DO - 10.1212/CON.0000000000000270
M3 - Review article
C2 - 26844738
AN - SCOPUS:84957624471
VL - 22
SP - 204
EP - 226
JO - CONTINUUM Lifelong Learning in Neurology
JF - CONTINUUM Lifelong Learning in Neurology
SN - 1080-2371
ER -