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 Usher syndrome: Gene therapy restores hearing and balance
25.09.2017 | Institut Pasteur

nachricht MRI contrast agent locates and distinguishes aggressive from slow-growing breast cancer
25.09.2017 | Case Western Reserve University

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: The fastest light-driven current source

Controlling electronic current is essential to modern electronics, as data and signals are transferred by streams of electrons which are controlled at high speed. Demands on transmission speeds are also increasing as technology develops. Scientists from the Chair of Laser Physics and the Chair of Applied Physics at Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) have succeeded in switching on a current with a desired direction in graphene using a single laser pulse within a femtosecond ¬¬ – a femtosecond corresponds to the millionth part of a billionth of a second. This is more than a thousand times faster compared to the most efficient transistors today.

Graphene is up to the job

Im Focus: LaserTAB: More efficient and precise contacts thanks to human-robot collaboration

At the productronica trade fair in Munich this November, the Fraunhofer Institute for Laser Technology ILT will be presenting Laser-Based Tape-Automated Bonding, LaserTAB for short. The experts from Aachen will be demonstrating how new battery cells and power electronics can be micro-welded more efficiently and precisely than ever before thanks to new optics and robot support.

Fraunhofer ILT from Aachen relies on a clever combination of robotics and a laser scanner with new optics as well as process monitoring, which it has developed...

Im Focus: The pyrenoid is a carbon-fixing liquid droplet

Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.

A warming planet

Im Focus: Highly precise wiring in the Cerebral Cortex

Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.

The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...

Im Focus: Tiny lasers from a gallery of whispers

New technique promises tunable laser devices

Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

“Lasers in Composites Symposium” in Aachen – from Science to Application

19.09.2017 | Event News

I-ESA 2018 – Call for Papers

12.09.2017 | Event News

EMBO at Basel Life, a new conference on current and emerging life science research

06.09.2017 | Event News

 
Latest News

Nerves control the body’s bacterial community

26.09.2017 | Life Sciences

Four elements make 2-D optical platform

26.09.2017 | Physics and Astronomy

Goodbye, login. Hello, heart scan

26.09.2017 | Information Technology

VideoLinks
B2B-VideoLinks
More VideoLinks >>>