WOMEN & EPILEPSY

Q.82. Can seizures worsen during menstruation? If so, what is the treatment for such seizures?

Ans: Yes, some seizures do get worsened during menstrual period. They are called 'Catamenial epilepsy'. There are many explanations for this
(a) Due to salt and water retention
(b) Hormone dependence / deficiency
(c)Increase dose requirement
Such women need to consult their neurologists or epileptologists to discuss the mode of treatment. They might require use of some other drugs also. Eg. Diamox, usually hormonal treatment is not recommended.

Q.83. Can women with epilepsy take oral pills for contraception?

Ans: Some antiepileptic drugs like Carbamazapine, Phenytoin interface and reduce the levels of contraception thus, increasing the chances of contraception failures. Hence alternate methods of contraception like condoms, loop or AED like which do not interface with oral contraception may be used.

Q.84. What pre-conception counseling to be given to 'Women with Epilepsy'?

Ans: It is desirable that a lady with epilepsy along with her spouse has detailed discussion before planning for pregnancy. This is known as pre-conceptional counseling.
(a) Planned pregnancy is always better than unplanned pregnancy
(b) Certain drugs can be avoided in such planned pregnancies; if possible they could use one drug rather than polytherapy (more than one drug).
(c) It is desirable to use AED in such a way that there is no fluctuation in serum level over day/night.
(d) Use of Folic acid as prophylaxis to prevent any problem in the foetus.
(e) These women if not elderly (above 30 years) can postpone their pregnancy if AEDs are due for withdrawal already.

Q.85. What is the effect of pregnancy on epilepsy?

Ans : Frequency of epileptic seizure can worsen during pregnancy. This could be due to:
(a) Increasing requirement of antiepileptic drugs due to increase in the weight
(b) Salt and water retention and dilution of antiepileptic drugs can occur
(c) Due to some hormonal changes that occurs during pregnancy

Q.86. What is the risk of congenital malformation of the babies of women with epilepsy?

Ans: Certain antiepileptic drugs such as Eptoin / Sodium Valproate if used during the early stages of pregnancy (before first six weeks) might cause some congenital defects in the newborns. The risk is said to be higher ( 3-4% ) compared to pregnant women without epilepsy.


Q.87. Is it possible for patients taking AED to breast feed safely?

Ans : Of course yes- largely there is no effect of drugs on the child, unless the mother is taking high dosages which may cause disorders in child.

Genetic counseling

Q.88. What is the risk of patient with epilepsy having a child with epilepsy?

Ans : The risk of developing epilepsy in general population is about 1% and certain types of epilepsy ( Not all ) the risk is slightly increases to 2% and if both parents or one parent or one sibling have epilepsy then the risk is 4%.