scholarly journals Special Considerations in the Management of Women with Epilepsy in Reproductive Years

2022 ◽  
Vol 12 (1) ◽  
pp. 88
Author(s):  
Krishna Parekh ◽  
Hannah Debra Kravets ◽  
Rebecca Spiegel
Keyword(s):  
Menstrual Cycle ◽  
Seizure Frequency ◽  
Seizure Control ◽  
Premenopausal Women ◽  
Psychological Effects ◽  
Hormonal Contraceptives ◽  
Seizure Recurrence ◽  
Patients With Epilepsy

Anti-seizure medications (ASMs) fail to prevent seizure recurrence in more than 30% of patients with epilepsy. The treatment is more difficult in premenopausal women with epilepsy (WWE) because changes in plasma estrogen and progesterone concentrations during the menstrual cycle often affect seizure frequency and intensity. Interactions between enzyme-inducin ASMs and hormonal contraceptives can lead to both a loss of seizure control and failure of contraception. Significant changes in the function of the liver and kidneys during pregnancy can accelerate metabolism and elimination of ASMs, causing breakthrough seizures. In addition, the teratogenic, cognitive, and psychological effects of ASMs on potential offspring have to be considered when choosing the best ASM regimen. Therefore, aspecialized approach is necessary for the treatment of premenopausal WWE.

scholarly journals The effects of epileptic seizures upon quality of life

2009 ◽  
Vol 15 (3) ◽  
pp. 110-113 ◽  
Author(s):  
Priscila Camile Barioni Salgado ◽  
Fernando Cendes
Keyword(s):  
Quality Of Life ◽  
Seizure Frequency ◽  
Seizure Control ◽  
Epileptic Seizures ◽  
Anxiety And Depression ◽  
Co Morbidity ◽  
Item Quality ◽  
Patients With Epilepsy ◽  
And Control

OBJECTIVE: understand the psychological considerations of the relationship between the effect of seizures upon the patients' perception of seizure control, depression, anxiety and quality of life (QoL). METHODS: 151 adult patients with epilepsy diagnosed for over two years were interviewed and responded the 31-Item Quality of Life in Epilepsy (QOLIE-31), the Trait Form of the State/Trait Anxiety Inventory (STAI II) and the Beck Depression Inventory (BDI). RESULTS: 45 patients were depressed (29.8%) and 29 (19.2%) had anxiety. Depression scores ranged from 0 to 49 (M=7.4; SD=8.9) and anxiety scores ranged from 19 to 69 (M=41.5, SD=11.9). Total QoL score was correlated to seizure control (p<0.001), perception of epilepsy control (p<0.001), anxiety (p<0.001), and depression (p=0.003). The perception of epilepsy control was correlated to seizure control (p<0.001), seizure frequency (p=0.001), anxiety (p<0.001) and depression (p<0.001). Seizure control was associated to anxiety (p=0.033) and depression (p<0.001). There was co-morbidity between anxiety and depression (p<0.001). CONCLUSION: This study highlights the importance of the seizure frequency and control to the evaluation of perception of epilepsy control and shows that anxiety and depression in epilepsy are predicted by seizure-related (seizure frequency and control) and psychosocial aspects (perception of control and QoL) together.

scholarly journals Depression in Patients with Epilepsy in Nigeria: Phenomenology and Predictors

2021 ◽  
Author(s):  
Temitope Ogundare
Keyword(s):  
Logistic Regression ◽  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Seizure Frequency ◽  
Seizure Control ◽  
Independent Predictor ◽  
Major Depressive ◽  
The Mean ◽  
Patients With Epilepsy ◽  
Single Predictor

Abstract Objectives To determine the correlates of depression among patients with epilepsy in Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria. Methods 270 patients with epilepsy attending the outpatient clinic of the hospital were recruited and assessed using sociodemographic questionnaire, MINI-Plus, and BDI-II. Results The mean (standard deviation [SD]) age of the respondents was 32 (9.9) years, 45.6% were females, and 38.5% were married. Thirty-two (11.9%) patients had a diagnosis of major depressive disorder (MDD) and 13 (4.8%) had a diagnosis of dysthymia. The most common depressive symptoms were loss of pleasure (84.4%), crying (84.4%), self-dislike (81.3%), and loss of energy, tiredness/fatigue, indecisiveness and punishment feelings (78.1% each). Vegetative symptoms such as changes in appetite and sleep and loss of interest in sex were the least common depressive symptoms. In the logistic regression, seizure frequency was the single predictor of MDD and dysthymia. Patients who had at least one seizure per week were five times more likely to develop MDD (OR = 5.1, p = 0.014) and 16 times likely to have dysthymia (OR= 16.0, p = 0.0007). Patients who had at least one seizure per month were 3 times more likely to develop MDD (OR = 3.3, p = 0.029). Conclusion Seizure frequency is an independent predictor of depression among patients with epilepsy. Patients with poor seizure control are at higher risk of developing depression and should be routinely screened for depression.

scholarly journals Seizure frequency and obstetric complications at advanced maternal age: a preliminary observational study in women with epilepsy

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Hui Gao ◽  
Nanya Hao ◽  
Shanrui Liu ◽  
Dong Zhou
Keyword(s):  
Seizure Frequency ◽  
Maternal Age ◽  
Seizure Control ◽  
Advanced Maternal Age ◽  
Obstetric Complications ◽  
Obstetric Outcomes ◽  
Treatment Change ◽  
Hospital Patients ◽  
Patients With Epilepsy

Abstract Background Seizure control during pregnancy and obstetric outcomes are of important concerns for women with epilepsy (WWE) and their families. Advanced maternal age (≥35 years) shows a growing trend in the society with changes of lifestyle, which also occurs in diseased populations. The advanced maternal age is an independent factor for some unsatisfying obstetric outcomes. In this study we explored the seizure control and obstetric complications associated with advanced maternal age in WWE. Methods This study was based on the epilepsy pregnancy registry at West China Hospital. Patients with epilepsy in this registry who were aged 35 or older when starting pregnancy were included in this study. Their basic demographics and detailed information on epilepsy management and obstetric issues in all trimesters and during 1-year follow-up after birth were documented and reviewed. Data were processed by IBM SPSS version 22.0. The demographic characteristics, seizure frequency, treatment change, obstetric complications, and outcomes were analyzed and compared. Results Fifteen patients were included in this study, with an average age of 36.32 ± 2.39 years at pregnancy, and 73.33% of them were primiparas. The change of seizure frequency during pregnancy was not in a clear pattern, but there was an increased incidence of tonic-clonic seizures during the mid- and last trimesters. More than 20% of the patients had obstetric complications throughout the trimesters, including vaginal bleeding, hypothyroidism, and pre-eclampsia. The pre-eclampsia seemed extraordinarily complicated with other conditions. However, none of the complications were related with malformations or poor outcome of babies after 1-year follow-up. Conclusion Advanced maternal age combined with WWE is associated with frequent common obstetric complications. Future controlled studies with large sample sizes are needed to explore the related risks in comparison with other WWE and non-epileptic populations.

Sleep and epilepsy—chicken or egg?

2018 ◽  
Author(s):  
Dora A. Lozsadi
Keyword(s):  
Side Effects ◽  
Sleep Disorders ◽  
Learning Disability ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Seizure Control ◽  
Subjective Sleep ◽  
Neurological Conditions ◽  
The Uk ◽  
Patients With Epilepsy

Epilepsy is the commonest serious chronic neurological condition, affecting 0.5% of the population in the UK. Subjective sleep disturbance and excessive daytime sleepiness are reported to be 50% more frequent in those with epilepsy than in controls. Causes are multiple. Both poor seizure control and nocturnal attacks are known to contribute to such sleep disorders. Epilepsy also increases the risk of associated sleep disorders, and additional neurological conditions, such as dementia, learning disability, and depression. These all affect sleep hygiene. Prescribed anti-epileptic drugs will further aggravate the problem. Side-effects will include drowsiness. Sedating benzodiazepines and barbiturates are considered worst offenders. Others affect sleep architecture to varying degrees and/or cause insomnia. While hyper-somnolence in patients with epilepsy will raise the possibility of any of the above issues, sleep deprivation is one of the commonest seizure triggers. This chapter will shed more light on the intricate relationship between sleep and epilepsy.

scholarly journals Exogenous female sex steroid hormones and risk of asthma and asthma-like symptoms: a cross sectional study of the general population

Thorax ◽  
2001 ◽  
Vol 56 (8) ◽  
pp. 613-616
Author(s):  
P Lange ◽  
J Parner ◽  
E Prescott ◽  
C Suppli Ulrik ◽  
J Vestbo
Keyword(s):  
General Population ◽  
Postmenopausal Women ◽  
Hormone Replacement ◽  
Premenopausal Women ◽  
Cross Sectional Study ◽  
Asthma Medication ◽  
Hormonal Contraceptives ◽  
Cross Sectional ◽  
Heart Study ◽  
Prescription Practice

BACKGROUNDRecent evidence suggests a role for hormonal factors in the aetiology of asthma.METHODSData from a large study of women selected from the general population were used to relate treatment with oral hormonal contraceptives (OCP) and postmenopausal hormone replacement therapy (HRT) to the following asthma indicators: self-reported asthma, wheezing, cough at exertion, and use of medication for asthma. The study sample comprised 1536 premenopausal and 3016 postmenopausal women who participated in the third round of the Copenhagen City Heart Study in 1991–4. A total of 377 women were taking OCP (24.5% of premenopausal women) and 458 were on HRT (15.2% of postmenopausal women).RESULTSIn premenopausal women 4.8% reported having asthma. The prevalence of self-reported asthma, wheeze, use of asthma medication, and cough at exertion was not significantly related to use of OCP. In postmenopausal women the prevalence of self-reported asthma was 6.2%. A weak but consistent association was observed between HRT and self-reported asthma (OR 1.42 (95% CI 0.95 to 2.12)), wheeze (OR 1.29 (95% CI 1.02 to 1.64)), cough at exertion (OR 1.34 (95% CI 1.01 to 1.77)), and use of asthma medication (OR 1.45 (95% CI 0.97 to 2.18)).CONCLUSIONSIn this study of the general population no relationship was found between the use of OCP and asthma. Although an association was observed between HRT and asthma and asthma-like symptoms, this was relatively weak and it is concluded that there is no necessity to change present prescription practice.

Influence of timing of surgery during menstrual cycle on survival of premenopausal women with operable breast cancer

The Breast ◽  
1995 ◽  
Vol 4 (1) ◽  
pp. 19-24 ◽  
Author(s):  
P.S. Stonelake ◽  
J. Powell ◽  
J.A. Dunn ◽  
J. Warwickt ◽  
S.R. Bramhall ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Menstrual Cycle ◽  
Premenopausal Women ◽  
Operable Breast Cancer ◽  
Timing Of Surgery

scholarly journals Cyclic changes in lipoprotein and apolipoprotein levels during the menstrual cycle in healthy premenopausal women on a controlled diet.

1996 ◽  
Vol 81 (10) ◽  
pp. 3599-3603 ◽  
Author(s):  
R A Muesing ◽  
M R Forman ◽  
B I Graubard ◽  
G R Beecher ◽  
E Lanza ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Premenopausal Women ◽  
Cyclic Changes

Impact of vascular liver disease on the menstrual cycle and metabolic status in premenopausal women

2021 ◽  
pp. 101756
Author(s):  
Tatiana Stempak-Droissart ◽  
Christine Rousset-Jablonski ◽  
Poli M Spritzer ◽  
Najiba Lalhou ◽  
Etienne Larger ◽  
...  
Keyword(s):  
Liver Disease ◽  
Menstrual Cycle ◽  
Premenopausal Women ◽  
Metabolic Status

scholarly journals First, do no harm: the risks of overtreating children with epilepsy

2007 ◽  
Vol 65 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Eunice Chuang ◽  
Marilisa M. Guerreiro ◽  
Sara Y. Tsuchie ◽  
Angelica Santucci ◽  
Carlos A. M. Guerreiro ◽  
...  
Keyword(s):  
Adverse Events ◽  
Prospective Study ◽  
Antiepileptic Drug ◽  
Antiepileptic Drugs ◽  
Seizure Frequency ◽  
Seizure Control ◽  
Control Method ◽  
Refractory Epilepsy ◽  
Do No Harm ◽  
A Prospective Study

BACKGROUND: Although overtreatment with antiepileptic drugs contributes to the morbidity associated with epilepsy, many children still are overtreated. OBJECTIVE: To evaluate if the withdrawal of at least one antiepileptic drug (AED) in children with refractory epilepsy using polytherapy enable a better seizure control. METHOD: This was a prospective study. Children with refractory epilepsy using at least two AEDs were included. Once the patient, or guardian, agreed to participate in the study, one or more AED were slowly tapered off. The remaining AEDs dosages could be adjusted as needed, but a new AED could not be introduced. RESULTS: Fifteen patients were evaluated, three girls; ages ranging from 3 to 18 (mean=8.7 years). After at least one AED withdrawal, two (13.5%) patients became seizure free, seizures improved >50% in 5 (33.5%) patients, did not change in 5 (33.5%), and seizure frequency became worse in 3 (20%). Adverse events improved in 12 patients (80%). CONCLUSION: The withdrawal of at least one AED is a valuable option in the treatment of selected children with refractory epilepsy.

scholarly journals Interrelationship between radiologic findings and prognosis of epilepsy in children with neurocysticercosis

2002 ◽  
Vol 60 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Lisiane Seguti Ferreira ◽  
Verônica A. Zanardi ◽  
Min Li Li ◽  
Marilisa M. Guerreiro
Keyword(s):  
Disease Activity ◽  
Seizure Frequency ◽  
Statistical Difference ◽  
Seizure Control ◽  
Clinical Information ◽  
Radiologic Findings ◽  
Comparison Results ◽  
Before And After ◽  
Evolutive Stage ◽  
The Relationship

INTRODUCTION: Epileptic manifestations of Neurocysticercosis (NC) appear to depend on number and localization of the cysts. The objective of this study was to investigate the relationship between CT findings, number of parasites and the evolutive stage of the cysts, and the prognosis of epilepsy in children with NC. METHOD: We studied 28 patients with the parenchymal form of NC, considering: epilepsy duration; seizure frequency before and after AED treatment; seizure control; number of AED and recurrence after AED withdrawal. Clinical information was crossed with the number of lesions and disease activity in univariate comparison. RESULTS: The analysis of the clinical data in relation to the number of lesions and disease activity showed no statistical difference among the variables (p>0.05). CONCLUSION: We conclude that the course of epilepsy due to NC in childhood cannot be based exclusively on the number or stage of the parasites.

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