Women, epilepsy and anti-epileptic drugs

Epilepsy is a chronic disease interlinked with many aspects of a womans life. The objective for this syllabus is to review these aspects and update physicians treating epileptic women on the recent management recommendations in this population. Epilepsy is more common in males except in adolescence and the elderly. Certain epileptic syndromes are exclusively seen in females such as Rett syndrome, Aicardi syndrome and periventricular nodular heterotopia. Female sex hormones may alter seizure threshold in epileptic women and form the basis for catamenial epilepsy. Seizures particularly those of temporal lobe may influence the normal hormonal balance leading to menstrual irregularities and probable reduced fertility. Although most pregnant epileptic women have successful outcomes of their pregnancies, there is an increased risk of maternal and fetal complications during pregnancy and labor in comparison to non-epileptic women. Menopausal epileptic women receiving anti-epileptic drugs that interfere with calcium and vitamin metabolism are at a higher risk for osteoporosis.