Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Epilepsy presents unique problems for women

27.04.2004


Issues from fertility to contraception can be challenging



Anti-epileptic drugs (AEDs) are powerful medications that help women with epilepsy control their seizures; however, when these same women have to deal with reproductive issues and their epilepsy drugs, a myriad of problems can crop up, according to Mark Yerby, M.D., MPH, a leading expert in women’s issues and epilepsy. About 1 million of the estimated 2.5 million Americans with epilepsy are women.

Dr. Yerby is associate clinical professor of neurology, public health and preventive medicine, and obstetrics and gynecology at the Oregon Health Science University and director of the Epilepsy Program at Providence St. Vincent’s Medical Center, both in Portland, Ore. He spoke today at an American Medical Association media briefing in partnership with the American Academy of Neurology (AAN) and the American Epilepsy Society at the AAN’s annual meeting in San Francisco.


Hormonal changes may be responsible for some of the specific difficulties encountered by women with epilepsy. Many women find that their seizures change in severity or occur more frequently during puberty, pregnancy, when they are menstruating or during menopause.

"Pregnancy presents particular difficulties for women with epilepsy," Dr. Yerby said. "In pregnancy, drugs are generally contraindicated, but women with epilepsy cannot just simply stop taking their medications. If they do, they may have more seizures and risk injury to themselves and the fetus. They may be subject to other risks, such as losing their jobs or driver’s license."

Other adverse outcomes of uncontrolled seizures, Dr. Yerby noted, are fetal loss, infant mortality, decreased growth of the fetus and abnormal cognitive development (increased 2-fold in the children of women with epilepsy).

On the other hand, some AEDs are associated with a higher risk for birth defects. The fear of birth defects can cause women to stop taking their epilepsy medication. "People think drugs are bad--they forget about why we treat people with drugs in the first place," Dr. Yerby said. "There is great emphasis today on the hazards of medication--that’s okay, but people lose sight of the fact that having a seizure is a hazard."

Dr. Yerby suggests that women with epilepsy consult with their doctors to determine how they can remain on their medication while minimizing risk. "There are a number of options," Dr. Yerby stated. "We can adjust the dose of medication, change the medication and monitor its effectiveness, or withdraw medication altogether. It is best if we can get expectant mothers on a single medication that works to minimize side effects and risk." Women planning to conceive should consult closely with their physicians so their treatment plan can be determined in advance when possible.

Dr. Yerby added that breast-feeding is generally not problematic for the babies of women with epilepsy. "Usually the child has been exposed to the drugs for nine month in utero and by the time they are born they can metabolize their mother’s medication present in the breast milk," he explained. "The safety of newer drugs in both pregnancy and breastfeeding, however, is still being determined."

Other problems specific to women with epilepsy are that AEDs can decrease the efficacy of hormonal contraceptives (whether given by mouth, subcutaneously or by injection). "There are five AEDs that interfere with the efficacy of the pill and at least one AED that is affected by oral contraception," Dr. Yerby stated. "Sometimes we can overcome these problems by prescribing a higher-dose contraceptive. Women who have unplanned pregnancies should stay on their AEDs and notify their physician immediately."

"Women with epilepsy need special care in managing their disorder," Dr. Yerby stated. "They cannot safely stop taking their medication without risking seizures and injury to themselves and their unborn."


Media Advisory: To contact Mark S. Yerby, call 503-497-1091. On the day of the briefing, call the AMA’s Science News Department at 312-464-2410, the AAN Press Room at 415-978-3521 or email kstone@aan.com.

Jeanne Galatzer-Levy | EurekAlert!
Further information:
http://www.ama-assn.org/

More articles from Health and Medicine:

nachricht How cancer metastasis happens: Researchers reveal a key mechanism
19.01.2018 | Weill Cornell Medicine

nachricht Researchers identify new way to unmask melanoma cells to the immune system
17.01.2018 | Duke University Medical Center

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Artificial agent designs quantum experiments

On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.

We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...

Im Focus: Scientists decipher key principle behind reaction of metalloenzymes

So-called pre-distorted states accelerate photochemical reactions too

What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...

Im Focus: The first precise measurement of a single molecule's effective charge

For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.

Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...

Im Focus: Paradigm shift in Paris: Encouraging an holistic view of laser machining

At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.

No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...

Im Focus: Room-temperature multiferroic thin films and their properties

Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.

Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

10th International Symposium: “Advanced Battery Power – Kraftwerk Batterie” Münster, 10-11 April 2018

08.01.2018 | Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

 
Latest News

Let the good tubes roll

19.01.2018 | Materials Sciences

How cancer metastasis happens: Researchers reveal a key mechanism

19.01.2018 | Health and Medicine

Meteoritic stardust unlocks timing of supernova dust formation

19.01.2018 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>