Epilepsy in Women (eBook)

Cynthia Harden, Sanjeev V. Thomas, Torbjorn Tomson (Herausgeber)

eBook Download: PDF

2013
John Wiley & Sons (Verlag)
978-1-118-53107-5 (ISBN)

Infos

Epilepsy requires careful management and monitoring through a woman's life

Epilepsy is a complex disease. The hormonal changes women experience, both day-to-day menstrual fluctuations and the longer waxes and wanings of a reproductive lifetime, make the management of epilepsy even more complicated. At some point, the well-being of a second person, a fetus, might also have to be taken into account.

Epilepsy in Women provides a detailed guide to this challenge. The wide-ranging approach encompasses all aspects of a woman's life including:

• Social and psychological impacts
• The impact in reproductive life
• Contraception
• Pregnancy
• Fetal health and long term developmental outcomes
• Lactation
• Menopause

Each practical chapter begins and ends with a case study that demonstrates the more general challenge. The authors develop themes to provide clinical guidance based on evidence and experience.

Written and edited by an international cast of experts, Epilepsy in Women provides crucial tips and recommendations for neurologists and gynecologists who need to be aware of the subtle effects of epilepsy on woman's life.

Cynthia L. Harden, MD, Chief of the Comprehensive Epilepsy Care Institute, North Shore LIJ Health System and Professor of Neurology, Hofstra North Shore-LIJ School of Medicine, USA.

Sanjeev V Thomas, MD, Professor of Neurology, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695 011, India and Fulbright Visiting Professor, Ohio State University, Columbus, USA.

Torbjörn Tomson, MD, Professor of Neurology, especially epileptology, Department of Clinical Neuroscience, Karolinska Institutet, and consultant/senior physician at Department of Neurology, Karolinska University Hospital, Sweden.

Inhalt

Epilepsy in Women 5
Copyright 6
Contents 7
Preface 9
Contributors 11
Chapter 1 Gender Difference in Epidemiology and Comorbidities of Epilepsy 15
Background and important detail 15
Incidence of epilepsy 16
Prevalence of epilepsy 17
Epilepsy syndromes and comorbidity 18
Attitudes toward epilepsy and gender 19
Prognosis and mortality of epilepsy 20
Use of antiepileptic drugs 20
Implications for management 21
References 21
Chapter 2 The Social and Psychological Impacts of Epilepsy 25
Determinants of the social and psychological impacts of epilepsy 26
Epilepsy in the female child 29
The adolescent female with epilepsy 30
The adult female with epilepsy 31
The elderly female with epilepsy 32
References 34
Chapter 3 Neurosteroid Influences on Neuronal Excitability: The Menstrual Cycle and Catamenial Epilepsy as Dynamic Models 37
Introduction 37
The menstrual cycle 38
Catamenial epilepsy 40
Neuroendocrine aspects of catamenial epilepsy 42
Role of estrogens 42
Role of progesterone 43
Role of neurosteroids 44
Potential mechanisms of catamenial seizures 46
Progesterone therapy for catamenial epilepsy 48
Novel treatments for catamenial epilepsy 49
Conclusions 50
Acknowledgments 50
References 51
Chapter 4 Catamenial Epilepsy 55
Introduction to the field 55
Background and important details 57
Pathophysiology 59
Treatment 61
Hormonal treatment 61
Nonhormonal treatment 63
References 65
Chapter 5 Impact of Epilepsy and AEDs on Reproductive Health 67
Background and important details 67
Menstrual disorders 69
Polycystic ovary syndrome 70
Effect of epilepsy on hypothalamo-pituitary axis 70
Effect of AEDs on endogenous hormones 71
Implications for management 73
References 75
Chapter 6 Contraception and Epilepsy 78
Background and important detail 78
Hormonal contraceptive methods 79
Pharmacokinetic interactions between contraceptive hormones and AEDs 80
Hormonal contraception and seizure control 82
Intrauterine contraception 83
Dual benefit of pregnancy prevention and decreased menstrual bleeding 83
Implications for management 84
References 85
Chapter 7 Diagnostic Challenges with Seizures in Pregnancy 89
Seizures in pregnancy 89
Eclampsia 91
Electroencephalography 92
Brain imaging 92
Treatment 93
Posterior reversible encephalopathy syndrome 94
Reversible cerebral vasoconstriction syndrome 94
Stroke during pregnancy 94
Cerebral venous thrombosis 96
Vascular malformations 97
Postpartum cerebral angiopathy 98
Amniotic fluid embolism 98
Central nervous system infections 99
Neurocysticercosis 99
Tuberculoma 100
Autoimmune encephalitis 100
Brain tumors 101
Diagnostic approach 101
History 101
Examination 101
References 103
Chapter 8 Seizure Control During Pregnancy 105
Background and details 105
Seizure control in pregnancy 106
Alterations in seizure control in different stages of pregnancy, labor, and delivery 107
Risk factors for deteriorated seizure control 108
Measures to reduce the risk of seizures during pregnancy 110
Implications for management 111
The role of pre-conception counseling and patient education 111
References 113
Chapter 9 Effect of Pregnancy on AED Kinetics 115
Introduction 115
Implications of AED pharmacokinetics before pregnancy 116
Pharmacokinetic changes during pregnancy 117
General aspects 117
Pharmacokinetic changes detailed by medication 119
Implications of AED pharmacokinetics after birth 122
Implications for management 123
References 125
Chapter 10 Fetal and Maternal Risks with Seizures 129
General effects of seizures 129
Lactic acidosis 129
Circulatory changes 131
Uterine contractions 131
Trauma to the uterus 132
Seizures and fetal malformations 132
Current reports on the risk of seizures causing malformations 132
Evaluating teratogenic effects of seizures 132
Limitations in register-based research 133
Seizures and spontaneous abortions 133
Results in current reports 133
Definition of spontaneous abortion 133
Seizures and common obstetric complications 133
Occurrence of pregnancy complications in women with epilepsy 133
Role of seizures in pregnancy complications 134
Seizures and maternal deaths 134
Seizures and stillbirths 135
Seizures and childbirth (i.e., labor, delivery and early puerperium) 136
Probability of seizures during childbirth 136
Effects of seizures during childbirth 136
Seizure at childbirth: eclampsia, epilepsy or something else? 136
Late child effects of maternal seizures during pregnancy 137
Clinical studies 137
Experimental studies 137
Implications for management 138
References 139
Chapter 11 Obstetrical Outcome and Complications of Pregnancy 142
Introduction 142
Pre-conception dialogue 143
Folate use 143
Complications of pregnancy 144
Delivery 145
Obstetrical outcome 146
Implications for management 146
References 147
Chapter 12 Mechanisms of Teratogenic Effects of AEDs 150
Background and important detail 150
Epoxidation 151
Oxidative stress 152
Altered folate metabolism 154
Histone deacetylases 155
Implications for management 157
References 159
Chapter 13 Major Congenital Malformations in Offspring of Women with Epilepsy 162
Introduction and background 162
Some methodological considerations 164
Major congenital malformations and AED exposure 166
Conclusions 174
References 175
Chapter 14 Fetal AED Syndromes 178
Background and important details 178
Implications for management 180
Active treatment and screening 180
Prevention of recurrence 181
References 182
Chapter 15 Postnatal Cognitive Development 184
Background 184
Cognitive effects of maternal epilepsy in absence of AEDs during pregnancy 185
Cognitive effects of maternal seizures during pregnancy 185
Cognitive effects of fetal AED exposure 185
Other factors 185
Pregnancy outcomes with regard to neurodevelopment 186
Effects of fetal AED exposure on neurodevelopment 186
Possible mechanisms of behavioral teratogenesis 186
Neurodevelopmental effects of individual AEDs 188
Carbamazepine 188
Lamotrigine 188
Levetiracetam 189
Phenobarbital 189
Phenytoin 190
Valproate 190
Benzodiazepines 191
Other AEDs 191
Polytherapy 192
Breastfeeding and AEDs 192
Conclusions on cognitive outcomes from human studies 192
Implications for management 192
References 194
Chapter 16 Management of the Postpartum Period and Lactation 198
Breastfeeding: background and benefits 198
Women with epilepsy and breastfeeding 199
Breastfeeding guidelines 201
Effects on cognition in offspring exposed to AEDs through breastfeeding 204
Safety issues 204
Depression 205
Contraception in the immediate postpartum period 206
Implications for management 206
References 207
Chapter 17 Management of Epilepsy and Pregnancy 210
Prior to planning pregnancy 211
During pregnancy 212
After delivery 213
References 213
Chapter 18 Perimenopause and Menopause 214
Background 214
Implications for management 216
References 217
Chapter 19 Bone Health 219
Background 219
Implications for management 221
References 222
Index 225

Produkt-Details

• Erscheint lt. Verlag: 2.1.2013
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Neurologie
• Schlagworte: Account • Aspects • Careful • challenge • Complex • Complicated • daytoday • Disease • Epilepsie • Epilepsy • Experience • Fluctuations • Guide • Gynäkologie u. Geburtshilfe • Gynäkologie u. Geburtshilfe • Life • Lifetime • Management • Medical Science • Medizin • menstrual • Neurologie • Neurology • Obstetrics & Gynecology • Person • Point • provides • Reproductive • requires • Second • womans • Women
• ISBN-10: 1-118-53107-8 / 1118531078
• ISBN-13: 978-1-118-53107-5 / 9781118531075