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 Nitric oxide-scavenging hydrogel developed for rheumatoid arthritis treatment
06.06.2019 | Pohang University of Science & Technology (POSTECH)

nachricht Infants later diagnosed with autism follow adults’ gaze, but seldom initiate joint attention
24.05.2019 | Schwedischer Forschungsrat - The Swedish Research Council

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 hidden structure of the periodic system

The well-known representation of chemical elements is just one example of how objects can be arranged and classified

The periodic table of elements that most chemistry books depict is only one special case. This tabular overview of the chemical elements, which goes back to...

Im Focus: MPSD team discovers light-induced ferroelectricity in strontium titanate

Light can be used not only to measure materials’ properties, but also to change them. Especially interesting are those cases in which the function of a material can be modified, such as its ability to conduct electricity or to store information in its magnetic state. A team led by Andrea Cavalleri from the Max Planck Institute for the Structure and Dynamics of Matter in Hamburg used terahertz frequency light pulses to transform a non-ferroelectric material into a ferroelectric one.

Ferroelectricity is a state in which the constituent lattice “looks” in one specific direction, forming a macroscopic electrical polarisation. The ability to...

Im Focus: Determining the Earth’s gravity field more accurately than ever before

Researchers at TU Graz calculate the most accurate gravity field determination of the Earth using 1.16 billion satellite measurements. This yields valuable knowledge for climate research.

The Earth’s gravity fluctuates from place to place. Geodesists use this phenomenon to observe geodynamic and climatological processes. Using...

Im Focus: Tube anemone has the largest animal mitochondrial genome ever sequenced

Discovery by Brazilian and US researchers could change the classification of two species, which appear more akin to jellyfish than was thought.

The tube anemone Isarachnanthus nocturnus is only 15 cm long but has the largest mitochondrial genome of any animal sequenced to date, with 80,923 base pairs....

Im Focus: Tiny light box opens new doors into the nanoworld

Researchers at Chalmers University of Technology, Sweden, have discovered a completely new way of capturing, amplifying and linking light to matter at the nanolevel. Using a tiny box, built from stacked atomically thin material, they have succeeded in creating a type of feedback loop in which light and matter become one. The discovery, which was recently published in Nature Nanotechnology, opens up new possibilities in the world of nanophotonics.

Photonics is concerned with various means of using light. Fibre-optic communication is an example of photonics, as is the technology behind photodetectors and...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

SEMANTiCS 2019 brings together industry leaders and data scientists in Karlsruhe

29.04.2019 | Event News

Revered mathematicians and computer scientists converge with 200 young researchers in Heidelberg!

17.04.2019 | Event News

First dust conference in the Central Asian part of the earth’s dust belt

15.04.2019 | Event News

 
Latest News

Uncovering hidden protein structures

18.06.2019 | Life Sciences

Monitoring biodiversity with sound: how machines can enrich our knowledge

18.06.2019 | Life Sciences

Schizophrenia: Adolescence is the game-changer

18.06.2019 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>