Features of diagnosis and treatment of reproductive health of women with epilepsy: A literature review
DOI:
https://doi.org/10.37800/RM.2.2024.45-53Keywords:
epilepsy, women, reproductive health, hormonal influences, antiepileptic drugs, pregnancy and epilepsy, partial and generalized seizuresAbstract
Relevance: Epilepsy in women presents a complex medical problem affecting various aspects of the reproductive cycle, including sexual development, pregnancy, breastfeeding, and menopause.
The study aimed to assess the impact of epilepsy and antiepileptic drugs on reproductive health, sexual function, and the mental state of women, as well as developing recommendations to optimize treatment and improve the quality of life of women with epilepsy.
Materials and Methods: A systematic review of scientific literature was conducted to achieve this goal, including analyzing articles published in peer-reviewed medical journals. The main focus was on studies related to catamenial epilepsy, reproductive and sexual dysfunction, psychiatric disorders, and their relationship with the use of antiepileptic drugs. Content analysis methods were used to identify key aspects and trends in this field.
Results: As a result of the systematic review, it was found that epilepsy in women significantly affects various aspects of their reproductive and mental health. Studies also showed that polycystic ovary syndrome is more common in women taking valproate, highlighting the need for careful selection of antiepileptic drugs. It was established that pregnancy in women with epilepsy requires careful monitoring of antiepileptic drug levels and dose minimization to ensure the safety of both the mother and the fetus. Psychiatric disorders such as depression and anxiety are common comorbid conditions that require special attention during treatment.
Conclusion: This review may interest clinicians, patients, and researchers seeking to improve the treatment outcomes in women of reproductive age with epilepsy and their quality of life. Epilepsy in women requires a comprehensive and individual approach to treatment, taking into account reproductive and hormonal changes. In the therapeutic and diagnostic process, patients’ education and active participation are of particular importance in making decisions about treatment and consulting and monitoring their condition before conception in different phases of life. This approach helps to improve the health and quality of life of women with epilepsy.
References
Stephen LJ, Harden C, Tomson T, Brodie MJ. Management of epilepsy in women. Lancet Neurol. 2019;18(5):481-491.
https://doi.org/10.1016/s1474-4422(18)30495-2
Maguire MJ, Weston J, Singh J, Marson AG. Antidepressants for people with epilepsy and depression. Cochrane Database Syst Rev. 2014;2014(12):Cd010682.
https://doi.org/10.1002/14651858.CD010682.pub2
Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, Engel J, Forsgren L, French JA, Glynn M, Hesdorffer DC, Lee BI, Mathern GW, Moshé SL, Perucca E, Scheffer IE, Tomson T, Watanabe M, Wiebe S. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-482.
https://doi.org/10.1111/epi.12550
Soh H, Pant R, LoTurco JJ, Tzingounis AV. Conditional deletions of epilepsy-associated KCNQ2 and KCNQ3 channels from cerebral cortex cause differential effects on neuronal excitability. J Neurosci. 2014;34(15):5311-21.
https://doi.org/10.1523/jneurosci.3919-13.2014
Niday Z, Hawkins VE, Soh H, Mulkey DK, Tzingounis AV. Epilepsy-Associated KCNQ2 Channels Regulate Multiple Intrinsic Properties of Layer 2/3 Pyramidal Neurons. J Neurosci. 2017;37(3):576-586.
https://doi.org/10.1523/jneurosci.1425-16.2016
Яхьярова М., Заставский И., Ким А. Наступление беременности и роды у пациенток после коррекции расположения пронуклеусов в ооцитах с использованием ионофора кальция. Репрод Мед. 2022;4(53):87-92.
Yax'yarova M, Zastavskij I, Kim A. Pregnancy and childbirth in patients after correction of the location of pronuclei in oocytes using an ionophore. Reprod. Med. 2022;4(53):87-92. (in Russ.).
https://doi.org/10.37800/RM.3.2022.87-92.
Menon S, Siewe Fodjo JN, Weckhuysen S, Bhwana D, Njamnshi AK, Dekker M, Colebunders R. Women with epilepsy in sub-Saharan Africa: A review of the reproductive health challenges and perspectives for management. Seizure. 2019;71:312-317.
https://doi.org/10.1016/j.seizure.2019.08.016
Herzog AG, MacEachern DB, Mandle HB, Cahill KE, Fowler KM, Davis AR, Allen Hauser W. Folic acid use by women with epilepsy: Findings of the Epilepsy Birth Control Registry. Epilepsy Behav. 2017;72:156-60.
https://doi.org/10.1016/j.yebeh.2017.05.007
Galappatthy P, Liyanage CK, Lucas MN, Jayasekara D, Abhayaratna SA, Weeraratne C, De Abrew K, Gunaratne PS, Gamage R, Wijeyaratne CN. Obstetric outcomes and effects on babies born to women treated for epilepsy during pregnancy in a resource limited setting: a comparative cohort study. BMC Pregnancy Childbirth. 2018;18(1):230. https://doi.org/10.1186/s12884-018-1857-3
Jeon JY, Bae JG, Kim KT, Cho YW. Pregnancy and Epilepsy: a Korean Tertiary Epilepsy Center Review. J Korean Med Sci. 2020;35(19):e119.
https://doi.org/10.3346/jkms.2020.35.e119
Leite ML, Topocov TN, De Oliveira TL, Almeida DDS, Mota Ortiz SR, Da Silva JC. Obstetric and neonatal outcomes, antiseizure medication profile, and seizure types in pregnant women in a vulnerability state from Brazil. PLoS One. 2024;19(4):e0291190.
https://doi.org/10.1371/journal.pone.0291190
Nevitt SJ, Sudell M, Weston J, Tudur Smith C, Marson AG. Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data. Cochrane Database Syst Rev. 2017;6(6):Cd011412.
https://doi.org/10.1002/14651858.CD011412.pub2
Nevitt SJ, Sudell M, Cividini S, Marson AG, Tudur Smith C. Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data. Cochrane Database Syst Rev. 2022;4(4):Cd011412.
https://doi.org/10.1002/14651858.CD011412.pub4
Harden CL, Pennell PB. Neuroendocrine considerations in the treatment of men and women with epilepsy. The Lancet Neurology. 2013;12(1):72-83.
https://doi.org/10.1016/S1474-4422(12)70239-9
Maguire MJ, Nevitt SJ. Treatments for seizures in catamenial (menstrual-related) epilepsy. Cochrane Database Syst Rev. 2021;9(9):Cd013225.
https://doi.org/10.1002/14651858.CD013225.pub3
Gosset A., Denuelle M., Valton L., Sommet A., Bénévent J., Tremollières F. Interactions between antiseizure medications and contraception: A study about the knowledge of patients and their specialist physicians // Epilepsy Behav. – 2022. – Vol. 129. – P. 108627. https://doi.org/10.1016/j.yebeh.2022.108627
King A, Gerard EE. Contraception, fecundity, and pregnancy in women with epilepsy: an update on recent literature. Current opinion in neurology. 2022;35(2):161-168.
https://doi.org/10.1097/WCO.0000000000001039
Mandle HB, Cahill KE, Fowler KM, Hauser WA, Davis AR, Herzog AG. Reasons for discontinuation of reversible contraceptive methods by women with epilepsy. Epilepsia. 2017;58(5):907-914.
https://doi.org/10.1111/epi.13734
Sheikhalishahi A, Jahdi F, Haghani H. The relationship between sexual health and personality type in women with epilepsy. J Educ Health Promot. 2021;10:257.
https://doi.org/10.4103/jehp.jehp_1049_20
Kasar U, Dwivedi AK. Sexual Dysfunction and Associated Psychiatric Comorbidities Impacting Quality of Life in Epilepsy: A Review of Literature. Cureus. 2023;15(12):e51266.
https://doi.org/10.7759/cureus.51266
Viale L, Allotey J, Cheong-See F, Arroyo-Manzano D, McCorry D, Bagary M, Mignini L, Khan KS, Zamora J, Thangaratinam S. Epilepsy in pregnancy and reproductive outcomes: a systematic review and meta-analysis. Lancet. 2015;386(10006):1845-1852.
https://doi.org/10.1016/s0140-6736(15)00045-8
Falcicchio G, Russo E, Fabiano A, Scalese M, Boero G, Trojano M, De Tommaso M, La Neve A. Current safety concerns about the use of antiseizure medications in pregnancy. Expert opinion on drug safety. 2022;21(12):1459–1468.
https://doi.org/10.1080/14740338.2022.2160443
Voinescu PE, Pennell PB. Management of epilepsy during pregnancy. Expert Rev Neurother. 2015;15(10):1171-87. https://doi.org/10.1586/14737175.2015.1083422
Panebianco M, Rigby A, Marson AG. Vagus nerve stimulation for focal seizures. The Cochrane database of systematic reviews. 2022;7(7):CD002896.
https://doi.org/10.1002/14651858.CD002896.pub3
Bromley R, Weston J, Adab N, Greenhalgh J, Sanniti A, McKay AJ, Tudur Smith C, Marson AG. Treatment for epilepsy in pregnancy: neurodevelopmental outcomes in the child. Cochrane Database Syst Rev. 2014;2014(10):Cd010236.
https://doi.org/10.1002/14651858.CD010236.pub2
Shannon GD, Alberg C, Nacul L, Pashayan N. Preconception healthcare and congenital disorders: systematic review of the effectiveness of preconception care programs in the prevention of congenital disorders. Matern Child Health J. 2014;18(6):1354-1379.
https://doi.org/10.1007/s10995-013-1370-2
Bui E. Women's Issues in Epilepsy. Continuum (Minneap Minn). 2022;28(2):399-427.
https://doi.org/10.1212/con.0000000000001126
Traugott P, Medina A, Parker JM. Navigating the Complexity of a Bipolar Pregnant Patient With Multiple Comorbidities. Cureus. 2024;16(1):e51510.
https://doi.org/10.7759/cureus.51510
Jones I, Chandra PS, Dazzan P, Howard LM. Bipolar disorder, affective psychosis, and schizophrenia in pregnancy and the post-partum period. Lancet. 2014;384(9956):1789-1799.
https://doi.org/10.1016/s0140-6736(14)61278-2
Sobregrau P, Baillès E, Carreño M., Donaire A, Boget T, Setoain X, Bargalló N, Rumià J, Vives VSM, Pintor L. Psychiatric and psychological assessment of Spanish patients with drug-resistant epilepsy and psychogenic nonepileptic seizures (PNES) with no response to previous treatments. Epilepsy & behavior: E&B. 2023;145:109329.
https://doi.org/10.1016/j.yebeh.2023.109329
Okazaki M, Adachi N, Akanuma N, Hara K, Ito M, Kato M, Onuma T. Do antipsychotic drugs increase seizure frequency in epilepsy patients? Eur Neuropsychopharmacol. 2014;24(11):1738-1744.
https://doi.org/10.1016/j.euroneuro.2014.09.012
Li Q, Zhang Z, Fang J. Hormonal Changes in Women with Epilepsy. Neuropsychiatr Dis Treat. 2024;20:373-388. https://doi.org/10.2147/ndt.S453532
Аязбеков А., Нурхасимова Р., Аязбекова А., Курманова A. Ювенильная беременность как фактор перинатальных осложнений. Репрод Мед. 2022;1(50):77-84.
Ayazbekov A, Nurxasimova R, Ayazbekova A, Kurmanova A. Juvenile pregnancy as a factor of perinatal complications. Reprod. Med. 2022;1(50):77-84. (in Russ.).
https://doi.org/10.37800/RM.1.2022.77-84.
Milligan TA. Epilepsy: A Clinical Overview. Am J Med. 2021;134(7):840-847.
https://doi.org/10.1016/j.amjmed.2021.01.038
Mann C, Zinger E, Schmitz B, May T, Rosenow F, Pfäfflin M, Schulz J, Menzler K, Langenbruch L, Bierhansl L, Knake S, Hamacher M, Süß A, Von Podewils F, Schubert-Bast S, Strzelczyk A. Persistent knowledge gaps between 2005 and 2020 in women with epilepsy: Comparison of multicenter studies from Germany. Seizure. 2022;100:36-43.
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