Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-84b7d79bbc-4hvwz Total loading time: 0 Render date: 2024-07-26T14:55:52.190Z Has data issue: false hasContentIssue false

Chapter 17 - Reproductive Health for Women with Medication-Resistant Epilepsy

Published online by Cambridge University Press:  20 August 2020

By
Jiyeoun Yoo  and
Cynthia Harden
Edited by
John M. Stern ,
Raman Sankar  and
Michael Sperling
John M. Stern
Affiliation:
Geffen School of Medicine at UCLA, Los Angeles, CA
Raman Sankar
Affiliation:
Geffen School of Medicine at UCLA, Los Angeles, CA
Michael Sperling
Affiliation:
Jefferson Hospital for Neurosciences, Philadelphia, PA
Get access

Summary

When patients with epilepsy have seizures that are not completely controlled by medications, they are considered to have drug-resistant epilepsy. This condition is also known as medically intractable, medication-resistant, or medication-resistant epilepsy. The International League against Epilepsy defines this condition as the failure of adequate trials of two tolerated, appropriately chosen and administered antiepileptic drugs, whether as monotherapy or in combination, to achieve seizure freedom [1]. An estimated 30% of patients with epilepsy may be medication-resistant.

Type
Chapter
Information
Medication-Resistant Epilepsy
Diagnosis and Treatment
 , pp. 187 - 197
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kwan, P, Arzimanoglou, A, Berg, AT, et al., Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia 2010;51(6):1069–1077Google Scholar
Smith, SS. Estrogen administration increases neuronal responses to excitatory amino acids as a long-term effect. Brain Res 1989;503(2):354–357Google Scholar
Woolley, CS, McEwen, BS. Estradiol regulates hippocampal dendritic spine density via an N-methyl-D-aspartate receptor-dependent mechanism. J Neurosci 1994;14(12):7680–7687Google Scholar
Woolley, CS, McEwen, BS. Roles of estradiol and progesterone in regulation of hippocampal dendritic spine density during the estrous cycle in the rat. J Comp Neurol 1993;336(2):293–306CrossRefGoogle ScholarPubMed
Frye, CA. The neurosteroid 3 alpha, 5 apha-THP has antiseizure and possible neuroprotective effects in an animal model of epilepsy. Brain Res 1995;696(1–2):113–120Google Scholar
Herzog, AG. Catamenial epilepsy: definition, prevalence pathophysiology and treatment. Seizure 2008;17(2):151–159CrossRefGoogle ScholarPubMed
Herzog, AG, Klein, P, Ransil, BJ. Three patterns of catamenial epilepsy. Epilepsia 1997;38(10):1082–1088CrossRefGoogle ScholarPubMed
Cummings, LN, Giudice, L, Morrell, MJ. Ovulatory function in epilepsy. Epilepsia 1995;36(4):355–359CrossRefGoogle ScholarPubMed
Friedman, MN, Geula, C, Holmes, GL, Herzog, AG. GnRH-immunoreactive fiber changes with unilateral amygdala-kindled seizures. Epilepsy Res 2002;52(2):73–77Google Scholar
Amado, D, Cavalheiro, EA, Bentivoglio, M. Epilepsy and hormonal regulation: the patterns of GnRH and galanin immunoreactivity in the hypothalamus of epileptic female rats. Epilepsy Res 1993;14(2):149–159Google Scholar
Herzog, AG, Seibel, MM, Schomer, DL, Vaitukaitis, JL, Geschwind, N. Reproductive endocrine disorders in men with partial seizures of temporal lobe origin. Arch Neurol 1986;43(4):347–350Google Scholar
Herzog, AG, Seibel, MM, Schomer, DL, Vaitukaitis, JL, Geschwind, N. Reproductive endocrine disorders in women with partial seizures of temporal lobe origin. Arch Neurol 1986;43(4):341–346CrossRefGoogle ScholarPubMed
Herzog, AG, Coleman, AE, Jacobs, AR, et al. Relationship of sexual dysfunction to epilepsy laterality and reproductive hormone levels in women. Epilepsy Behav 2003;4(4):407–413Google Scholar
Isojarvi, JI, Laatikainen, TJ, Pakarinen, AJ, Juntunen, KT, Myllylä, VV. Polycystic ovaries and hyperandrogenism in women taking valproate for epilepsy. N Engl J Med 1993;329(19):1383–1388Google Scholar
Taubøll, E, Gregoraszczuk, EL, Wojtowicz, AK, Milewicz, T. Effects of levetiracetam and valproate on reproductive endocrine function studied in human ovarian follicular cells. Epilepsia 2009;50(8):1868–1874Google Scholar
Morrell, MJ, Giudice, L, Flynn, KL, et al. Predictors of ovulatory failure in women with epilepsy. Ann Neurol 2002;52(6):704–711Google Scholar
Hu, X, Wang, J, Dong, W, et al. A meta-analysis of polycystic ovary syndrome in women taking valproate for epilepsy. Epilepsy Res 2011;97(1–2):73–82Google Scholar
Wallace, H, Shorvon, S, Tallis, R. Age-specific incidence and prevalence rates of treated epilepsy in an unselected population of 2,052,922 and age-specific fertility rates of women with epilepsy. Lancet 1998;352(9145):1970–1973Google Scholar
Olafsson, E, Hauser, WA, Gudmundsson, G. Fertility in patients with epilepsy: a population-based study. Neurology 1998;51(1):71–73CrossRefGoogle ScholarPubMed
Sukumaran, SC, Sarma, PS, Thomas, SV. Polytherapy increases the risk of infertility in women with epilepsy. Neurology 2010;75(15):1351–1355CrossRefGoogle ScholarPubMed
Battino, D, Tomson, T, Bonizzoni, E, et al., Seizure control and treatment changes in pregnancy: observations from the EURAP epilepsy pregnancy registry. Epilepsia 2013;54(9):1621–1627Google Scholar
Thomas, SV, Syam, U, Devi, JS. Predictors of seizures during pregnancy in women with epilepsy. Epilepsia 2012;53(5):e85-e88CrossRefGoogle ScholarPubMed
Harden, CL, Hopp, J, Ting, TY, et al. Practice parameter update. Management issues for women with epilepsy – focus on pregnancy (an evidence-based review): obstetrical complications and change in seizure frequency. Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology 2009;73(2):126–132Google Scholar
Do Vale, TG, Da Silva, AV, Lima, DC, et al. Seizures during pregnancy modify the development of hippocampal interneurons of the offspring. Epilepsy Behav 2010;19(1):20–25CrossRefGoogle ScholarPubMed
Lima, DC, Vale, TG, Arganãraz, GA, et al. Behavioral evaluation of adult rats exposed in utero to maternal epileptic seizures. Epilepsy Behav 2010;18(1–2):45–49Google Scholar
Chen, YH, Chiou, HY, Lin, HC, Lin, HL. Affect of seizures during gestation on pregnancy outcomes in women with epilepsy. Arch Neurol 2009;66(8):979–984Google Scholar
Hernandez-Diaz, S, Smith, CR, Shen, A. Comparative safety of antiepileptic drugs during pregnancy. Neurology 2012;78(21):1692–1699CrossRefGoogle ScholarPubMed
Tomson, T, Battino, D, Bonizzoni, E, et al. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry. Lancet Neurol 2011;10(7):609–617Google Scholar
Vajda, FJ, O’Brien, TJ, Lander, CM, et al. Teratogenesis in repeated pregnancies in antiepileptic drug-treated women. Epilepsia 2013;54(1):181–186Google Scholar
Tomson, T, Battino, D, Bonizzoni, E, et al. Antiepileptic drugs and intrauterine death: a prospective observational study from EURAP. Neurology 2015;85(7):580–588Google Scholar
NEAD Study Group, Meador, KJ, Baker, GA, Browning, N, et al. Fetal antiepileptic drug exposure and cognitive outcomes at age 6 years (NEAD study): a prospective observational study. Lancet Neurol 2013;12(3):244–252CrossRefGoogle ScholarPubMed
Liverpool and Manchester Neurodevelopment Group, Bromley, RL, Mawer, G, Clayton-Smith, J, Baker, GA. Autism spectrum disorders following in utero exposure to antiepileptic drugs. Neurology 2008;71(23):1923–1924Google Scholar
Christensen, J, Grønborg, TK, Sørensen, MJ, et al. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. J Am Med Assoc 2013;309(16):1696–1703Google Scholar
Tomson, T, Landmark, CJ, Battino, D, et al. Antiepileptic drug treatment in pregnancy: changes in drug disposition and their clinical implications. Epilepsia 2013;54(3):405–414Google Scholar
EBM CONNECT Collaboration,Viale, L, Allotey, J, Cheong-See, F, et al. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet 2015;386(10006):1845–1852Google Scholar
Progesterone Trial Study Group, Herzog, AG, Fowler, KM, Smithson, SD, et al. Progesterone vs placebo therapy for women with epilepsy: A randomized clinical trial. Neurology 2012;78(24):1959–1966Google Scholar
Feely, M, Calvert, R, Gibson, J. Clobazam in catamenial epilepsy: a model for evaluating anticonvulsants. Lancet 1982;2(8289):71–73Google Scholar
Poser, CH. Letter: modification of therapy for exacerbation of seizures during menstruation. J Pediatr 1974;84(5):779–780CrossRefGoogle ScholarPubMed
American Academy of Neurology, American Epilepsy Society, Harden, CL, Pennell, PB, Koppel, BS, et al. Practice parameter update. Management issues for women with epilepsy–focus on pregnancy (an evidence-based review): vitamin K, folic acid, blood levels, and breastfeeding. Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology 2009;73(2):142–149Google Scholar
American Academy of Neurology, American Epilepsy Society, Harden, CL, Meador, KJ, Pennell, PB, et al. Practice parameter update. Management issues for women with epilepsy–focus on pregnancy (an evidence-based review): teratogenesis and perinatal outcomes. Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and American Epilepsy Society. Neurology 2009;73(2):133–141Google Scholar
Neurodevelopmental Effects of Antiepileptic Drugs (NEAD) Study Group, Meador, KJ, Baker, GA, Browning, N, et al. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years. JAMA Pediatr 2014;168(8):729–736Google Scholar
Bjork, MH, Veiby, G, Reiter, SC, et al. Depression and anxiety in women with epilepsy during pregnancy and after delivery: a prospective population-based cohort study on frequency, risk factors, medication, and prognosis. Epilepsia 2015;56(1):28–39Google Scholar
Morris, GL, 3rd, Gloss, D, Buchhalter, J, et al. Evidence-based guideline update: vagus nerve stimulation for the treatment of epilepsy. Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2013;81(16):1453–1459CrossRefGoogle Scholar
Scelzo, E, Mehrkens, JH, Bötzel, K, et al. Deep brain stimulation during pregnancy and delivery: experience from a series of “DBS Babies”. Front Neurol 2015;6:191Google Scholar
Harden, CL, Pennell, PB. Neuroendocrine considerations in the treatment of men and women with epilepsy. Lancet Neurol 2013;12(1):72–83Google Scholar
Harden, CL. Pregnancy and epilepsy. Continuum (Minneap Minn) 2014;20(1 Neurology of Pregnancy):60–79Google ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×