Management and health issues in women with epilepsy - a review

Although epilepsy affects men and women equally, there are special implications for women, especially during their childbearing years, and particularly when pregnancy is contemplated. This review summarisesthe complexity and multifaceted nature of health issues affecting women with epilepsy (WWE) in general and epilepsy in women beyond childbearing age. The female sex hormones and their cyclic as well as age-related variations certainly influence seizure activity and epilepsy in women. Catamenial epilepsy is a multifaceted neuroendocrine condition in which seizures are clustered around specific points in the menstrual cycle, most often around perimenstrual or periovulatory period. There are special concerns for women of child bearing years with regard to contraception, pregnancy and teratogenicity that should be considered during counseling and selection of appropriate treatment.Although the majority of pregnant WWE experience normal pregnancies and deliveries, their children have a higher risk of birth defects. Individualised treatment coupling antiepileptic drug use (AED) and the specific phase of impact of the reproductive cycle must be considered in treatment selection. As the number of available treatment options for epilepsy increases, the optimal goal for the general practitioner is to work as a team with obstetricians and gynaecologists, and neurologists in an effort to ensure the best treatment of WWE