Peculiarities of Epilepsy Treatment in Women of Childbearing Age
Keywords:
epilepsy, epilepsy in women, pregnancy, antiepileptic therapy, teratogenicityAbstract
The article is devoted to the peculiarities of epilepsy treatment in women of childbearing age. Physiological peculiarities of this category of patients, neuroendo-crine disorders, which may be a consequence of both the disease itself and the therapy administered, are discussed in detail. The data presented in the article indicate the need for a differentiated approach to the management of these patients, as well as the correct choice of antiepileptic drugs (AEDs) depending on the form of epilepsy, the type of seizures, and the potential effect of AEDs on hormonal status. When choosing antiepileptic drugs in girls and women of fertile age, preference should be given to new-generation drugs (lamotrigine and levetiracetam), taking into account the medicinal aspects of these drugs (interaction of AEDs among themselves, with hormonal contraceptives, the effect of drugs on the menstrual cycle, fertility indicators, teratogenicity).
References
Adab N., Kini U., Vinten J., Ayres J., Baker G., Clayton-Smithy J., Coyle H., Fryer A. et al. The longer term outcome of children born to mothers with epilepsy // J. Neurol. Neurosurg. Psychiatry. - 2004. - 75. - 1575-1583.
Bangar S, Shastri A., El-Sayeh H., Cavanna A.E. Women with epilepsy: clinically relevant issues//Functional Neurology. — 2016. — 31 (3). — 127-134.
Battino D, Tomson T, Bonizzoni E, Craig J., Lindhout D., Sabers A. et al. Seizure control and treatment changes in pregnancy: Observations from the EURAP epilepsy pregnancy registry // Epilepsia. — 2013. — 54 (9). — 1621-1627. http://doi; 10.1111/ epi.12302.
Borgelt L.M., Hart F.M., Bainbridge J.L. Epilepsy during pregnancy: focus on management strategies // International Journal of Women's Health. — 2016. — 8. — 505-517.
Bromley R, Weston J., Adab N. et al. Treatment for epilepsy in pregnancy: neurodevelopmental outcomes in the child // Cochrane Database Syst. Rev. — 10. — CD010236.
Cantwell R., Clutton-Brock T., Cooper G, Dawson A., Drife J., Garrod D., Harper A., Hulbert D. et al. Saving Mothers' Lives: reviewing maternal deaths to make motherhood safer; 2006—2008. The Eighth Report of the Confidential Enquires into Maternal Deaths in the United Kingdom // BJOG. — 2011. — 118 (Suppl. 1). — 1-203.
Christensen J., Gronborg T.K., Sorensen M.J., Schendel D., Parner E.T., Pedersen L.H. et al. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism // JAMA. — 2013. — 309. — 1696-1703.
Edey S., Moran N., Nashef L. SUDEP and epilepsy-related mortality in pregnancy // Epilepsia. — 2014. — 55 (7). — e72-e74, http://doi. 10.1111/epi.12621.
EURAP Study Group. Seizure control and treatment in pregnancy: observations from the EURAP epilepsy pregnancy registry // Neurology. — 2006. — 66. — 354-360.
