Best practice guidelines for the management of women with epilepsy

Crawford, Pamela; Appleton, Richard; Betts, Tim; Duncan, John S.; Guthrie, Eleanor; Morrow, James

doi:10.1053/seiz.1999.0295

Cited by 152 publications

(115 citation statements)

References 92 publications

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“…It has been inferred from this that folic acid may also be protective in women with epilepsy who have a higher than usual risk of neural tube defects. Despite the recommendations that high dose folate is prescribed for women with epilepsy,42, 43 there is no good evidence that this will protect against the neural tube defects, or other defects, seen in association with AEDs; indeed, there are some data to suggest that it does not 44. The effect of folate supplementation was reported for 4680 cases from the UK Epilepsy and Pregnancy Register 45.…”

Section: Other Issues To Be Coveredmentioning

confidence: 99%

Treating women with juvenile myoclonic epilepsy

Craig

Hunt²

2009

Pract Neurol

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Epilepsy has special implications for women, especially during their childbearing years, and particularly when pregnancy is contemplated. Being aware of the relevant issues is therefore essential. For anyone with juvenile myoclonic epilepsy and other idiopathic generalised epilepsies, valproate is generally regarded as the gold standard treatment against which other antiepileptic drugs are compared. However, information from pregnancy registers consistently show valproate to be associated with the highest risk for major congenital malformations, and studies exploring cognitive and behavioural development of offspring also show that valproate has an adverse impact. This creates a significant headache when trying to choose the "right" drug for most women with a generalised epilepsy syndrome.

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Section: Other Issues To Be Coveredmentioning

confidence: 99%

Treating women with juvenile myoclonic epilepsy

Craig

Hunt²

2009

Pract Neurol

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“…While guidelines on the management of pregnant women with epilepsy have been published in the specialist literature,11 recent evidence reveals that this mostly takes place in the primary care setting where knowledge remains poor. Early counselling of women in childbearing years is essential and the epilepsy specialist nurse working within specific adolescent clinics is an ideal model for provision of information.…”

Section: Teratogenicitymentioning

confidence: 99%

The Management of Epilepsy

Smith

Chadwick²

2001

Journal of Neurology, Neurosurgery &Amp; Psychiatry

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Epilepsy is a common, sometimes chronic, condition with physical risks and psychological and socioeconomic consequences which impair quality of life. The management of patients with epilepsy demands long term commitment from both the general practitioner (GP) and the specialist.The prime requirements are a complete diagnosis, selection of optimal treatment, and counselling appropriate to individual needs. The majority of patients will enter remission and may be discharged to the care of their GP, while the remainder need continued care in the specialist clinic.In the course of the condition the patient (and carer/family) should be suYciently well informed to make decisions about choices of treatment, the need for long term treatment, and options for dealing with the drug resistant condition and its consequences.Ideally this process will involve cooperation between the consultant and nurse specialist and the primary care physician. While, at present, these facilities are not widely available, this article focuses on this model of care. c STARTING TREATMENTThe decision to start treatment should not be taken lightly.1 It represents a balance between the likelihood of further seizures with their attendant risks, including the small but real risk of sudden unexpected death (SUDEP), 2 and the consequences, inconvenience, and risks of taking regular medication for each individual. Prophylactic treatmentProphylactic treatment has sometimes been advocated, notably in patients with severe head injury. While immediate treatment may reduce the risk of early post-traumatic seizures (within one week of injury) it does not influence the risk of late post-traumatic epilepsy.3 Studies addressing this issue in other neurological conditions with a high prospective risk of epilepsy (febrile seizures, craniotomy, cerebral tumours) have failed to show any evidence of benefit. Single seizuresPatients presenting with a first seizure, where avoidable provocative factors have been excluded, represent a common clinical dilemma. Methodological diVerences explain the widely varying estimates of risk of recurrence. Meta-analysis of prospective studies indicate an overall two year risk of 30-40%. The lowest risk (24%) is in patients with no identified cause who have a normal electroencephalogram (EEG), and the highest risk (65%) is in those with a remote neurological insult and an epileptiform EEG. 4 Treatment after a first tonic-clonic seizure halves the two year risk of seizures from approximately 40% to 20%.5 However, this is not associated with any improvement in longer term outcomes such as proportions of patients achieving a one year remission.While most neurologists do not advocate treatment routinely, patients who have a high risk of recurrence which would have significant social implications should be given the option and may elect to start treatment. Recurrent seizuresThe decision to start treatment is much more straightforward in a patient with recurrent seizures and a clear cut diagnosis of epilepsy, especially if he or she has an...

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“…Epi lepsy, a s on e of t he most stigmatizing diseases, significantly complicates the prospect of marriage and the creation of a family, and the most important issue for every woman -the possibility of having a child -causes a severe psycho-traumatic situation [4,5].…”

Section: Introductionmentioning

confidence: 99%

The Organization of Medical Care for Epilepsy in Pregnant Women

Rashidova¹

2018

J. res. health sci.

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Abstract:The issues of reproductive health of women with epilepsy are a significant problem of modern medicine. The proper management of women before and after pregnancy is an important step in preventing complications of the postpartum period, like woman with epilepsy and fetus. Treatment of women with epilepsy during pregnancy requires a special individual approach. Management of women with epilepsy of fertile age has its own characteristics and tactics, which must be taken into account individually with each patient.

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Best practice guidelines for the management of women with epilepsy

Cited by 152 publications

References 92 publications

Treating women with juvenile myoclonic epilepsy

Treating women with juvenile myoclonic epilepsy

The Management of Epilepsy

The Organization of Medical Care for Epilepsy in Pregnant Women

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