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Management of epilepsy in women

Department of Neurology, Guy’s Hospital, London, UK

Correspondence to:
Correspondence to:
Dr M D O’Brien
Department of Neurology, Guy’s Hospital, London SE1 9RT, UK; obrmd{at}btinternet.com

There are many aspects to the management of epilepsy in women related to their role in reproduction. Some of these need to be considered in adolescents, some are related to pregnancy, concerning both the mother and her infant, and others with the menstrual cycle and the menopause. This review considers contraception, fertility, teratogenicity, and the use of folic acid. It also discusses the special investigations in pregnancy, hyperemesis, the effect of pregnancy on the control of epilepsy, the effect of seizures on the fetus, a first fit in pregnancy, pseudoseizures, seizures during delivery, vitamin K, breast feeding, postpartum maternal epilepsy, hereditary risks, counselling, catamenial epilepsy, the menopause, and bone density.

Abbreviations: AED, antiepileptic drug; COC, combined oral contraceptive; EIAED, enzyme inducing antiepileptic drug; POP, progestogen only pill; MMR, major malformation rate; NTD, neural tube defect

Keywords: epilepsy

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