SummaryWomen with epilepsy (WWE) face specific challenges throughout their lifespan due to the effects of seizures and antiepileptic drugs on hormonal function, potentially affecting both sexual and reproductive health. This review article addresses the most common issues of practical relevance to clinicians treating WWE: epidemiology and clinical presentations (including catamenial epilepsy), contraception, reproductive and sexual dysfunction, pregnancy, lactation, menopause-related issues (including bone health), and mental health aspects. Awareness of these gender-specific issues and implementation/adaptation of effective interventions for WWE results in significantly improved health-related quality of life in this patient population.
While there are numerous studies that establish a clear relationship between obstructive sleep apnoea, cognitive decline and dementia, more work is needed in understanding the mechanism and processes involved. A detailed understanding of pathophysiology of sleep and the relationship with cognitive decline will be vital in addressing the possibility of averting a likely reversible cause of dementia or cognitive decline.
IntroductionCycloserine is a highly effective second line anti-tuberculosis medication, the use of which has increased in recent times due to emergence of multi-drug resistance. One of the side-effects is psychosis characterized by paranoia, hallucinations and affective instability. These symptoms are usually reported within the first 2 weeks of therapy in 30–50% of patients receiving Cycloserine 500 mg. At a dose of 100mg and above it leads to a hyperdopaminergic state which in turn could lead to psychosis. However, as this is a very effective treatment in people with multi-drug resistant tuberculosis, it is not always possible to omit treatment due to remergence of life threatening illness. We present findings from few patients on this medication who were referred to us for management of psychotic symptoms.Aims and objectivesTo treat the psychotic symptoms with anti-psychotic which would enable patient to continue Cycloserine. Also to monitor the response to an anti-psychotic.MethodsData was collected from the patient’s case notes, full psychiatric assessment and interviewing the relative. Patient was followed up in the out-patient clinic to monitor response to anti-psychotic medication.ResultsPatients were treated with both typical and atypical medication with good response and it was possible to continue with Cycloserine in one case.ConclusionCycloserine induced psychosis can mimic any other psychotic illness and can be effectively treated with anti-psychotics.
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