Women with epilepsy: clinically relevant issues

Bangar, Santosh; Shastri, Abhishek; El‐Sayeh, Hany; Cavanna, Andrea E.

doi:10.11138/fneur/2016.31.3.127

Cited by 27 publications

(30 citation statements)

References 77 publications

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“…The relationship between menstrual parameters and AED in the study will suggest carbamazepine may act at this level. Carbamazepine has been shown to impact on FSH level, as it aids conversion of inactive to active metabolite (Bangar et al2016, Svalheim et al, 2009, Verrotti et al, 2011 The fact that an ovulatory condition like polycystic ovarian syndrome is less common with carbamazepine contrary to the use of other anti-epileptic drugs that reduces the FSH level also supports this notion (Bangar et al, 2016;Svalheim et a l., 2009, Verrotti et al 2011. It is therefore explainable that values of LH/FSH among WWE not on carbamazepine were greater than 1 in our study.…”

Section: Discussionmentioning

confidence: 98%

The Hormonal Changes Among Nigerian Women With Epilepsy

Osalusi

Ogunjimi

Yaria

et al. 2020

AJSN

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This study aims to compare the sex hormones between women with epilepsy (WWE) and their agematched controls. We postulated that a difference in etiology, may be associated with an unexpected hormonal profile. A case control study carried out at the University College Hospital, Ibadan, South western, Nigeria involving seventy-five WWE and age-matched controls. Blood samples for hormonal evaluation follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen, progesterone and testosterone were taken twice from all the participants during their menstrual cycle. WWE had lower BMI (p: 0.004), cycle length (p: 0.014) and more menstrual pattern irregularities (p< 0.001.) In the pre-ovulatory phase, WWE had lower FSH levels when compared with controls, (p: 0.012). Further stratification shows a higher FSH levels among WWE on medication, (p: 0.003).In the mid-luteal phase, FSH level was lowest in WWE not on medication, WWE on medication had higher levels but lower when compared to the control group, p: 0.002. FWE had lower progesterone levels when compared with the control group, (p: 0.004) with no difference with use of AEDs. Testosterone levels were lower among those with symptomatic epilepsy, (p:0.012)WWE had lower progesterone, lower FSH and more menstrual abnormalities, compare to controls in our population.

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Section: Discussionmentioning

confidence: 98%

The Hormonal Changes Among Nigerian Women With Epilepsy

Osalusi

Ogunjimi

Yaria

et al. 2020

AJSN

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“…Prior studies including the International Registry of Antiepileptic Drugs and Pregnancy (EURAP) study found that the prepregnancy seizure baseline was the largest predictor of seizures during pregnancy itself, with 60% of women remaining seizure-free throughout their pregnancy. [39][40][41][42][43] EURAP also found that women with epilepsy did not have an increased risk of seizures during the second or third trimesters compared to their first trimester baseline. Likewise, a 7-year study of 841 women with epilepsy being treated with antiseizure drugs based on the Australian Register of Antiepileptic Drugs in Pregnancy found that a period of seizure freedom lasting at least 1 year prior to pregnancy was associated with a 50%-70% reduction in risk of seizures during pregnancy, as well as reduced risk of seizures in the first postpartum month.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy‐related complications and risk of postpartum readmission for seizures and epilepsy: A national study

et al. 2020

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Objective: Peripartum seizures remain a leading cause of maternal morbidity and mortality worldwide. Therefore, recognition of high-risk individuals is essential. We aimed to determine the rate and identify risk factors for postpartum seizure/epilepsy readmissions. Methods: In this retrospective cohort study, the Nationwide Readmissions Database was used to identify index admissions for delivery and readmissions for seizures in the year 2013, defined by International Classification of Disease, Ninth Revision, Clinical Modification codes for epilepsy, convulsions, and eclampsia in the primary diagnostic position. Logistic regression analysis was used to examine 30-day readmission for seizures as well as associations between demographic, medical, psychiatric, and pregnancy-related factors. Results: There were 1 633 714 index admissions for delivery, with a 30-day readmission rate for seizures/epilepsy of 19.69 per 100 000 index admissions. The mean age of index participants was 28.6 years (SD = 5.8). Postpartum 30-day readmissions for eclampsia represented 80% of seizure/epilepsy readmissions. Higher income was associated with lower odds of seizure/epilepsy readmission (odds ratio [OR] = 0.50, 95% confidence interval [CI] = 0.34-0.72, P = .03) for the highest income group.

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“…In general, newer AEDs have a safer risk profile to the unborn child. 28 Preconception folic acid can lessen the risk, particularly of neural tube defects. As such, all WWE of child-bearing age should receive preconception folic acid supplementation.…”

Section: Women's Issuesmentioning

confidence: 99%

Global Health: Epilepsy

Ali

2018

Semin Neurol

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Epilepsy is a frequently misunderstood and highly stigmatized condition. Major treatment gaps exist across the world, most so in areas of financial constraint. Classification permits the best approaches to treatment and to ascertaining prognosis. The International League Against Epilepsy's new classification system emphasizes clinical aspects and utilizes all available resources to determine whether it is a focal or generalized epilepsy. The most important tools are a careful history, clinical examination, electroencephalography, and appropriate neuroimaging. Inadequate, delayed, and incomplete evaluation may lead to misdiagnosis and costly mismanagement. Treatment is generally pharmacological, with approximately 20 to 30% of patients eventually proving refractory to medications and thus becoming potential surgical candidates. The type of epilepsy, age, gender, comorbidities, drug interactions, and drug cost are important factors in choosing an antiepileptic drug (AED). The teratogenic potential of some AEDs, weight gain, and menstrual hormone-related issues are important considerations in women. The impact of AEDs on bone health is critical in all age groups, particularly in the elderly. Psychiatric problems, mostly depression and anxiety, can have a great impact on seizure control and overall quality of life. Finally, effective partnerships and collaborations can bring resources, both human and financial, to regions that would otherwise find it impossible to effect change on their own.

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Women with epilepsy: clinically relevant issues

Cited by 27 publications

References 77 publications

The Hormonal Changes Among Nigerian Women With Epilepsy

The Hormonal Changes Among Nigerian Women With Epilepsy

Pregnancy‐related complications and risk of postpartum readmission for seizures and epilepsy: A national study

Global Health: Epilepsy

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