Epilepsy - hormones must be taken into account

[Posted: Fri 26/11/2010 by Deborah Condon www.irishhealth.com]

Doctors treating women with epilepsy need to take into account the role hormones can play, new research indicates.

Epilepsy is a neurological condition which is diagnosed when someone has recurrent seizures caused by excess electrical activity in the brain. Around 40,000 people in Ireland have the condition.

German researchers set out to establish how best to treat women with the condition by evaluating recommended guidelines and international literature on conception and pregnancy, contraception, hormonal influences and choice of medication.

The team from Munich University found that doctors need to take account of the specific hormonal situation in women, as such an approach can often reduce the limitations posed by the condition.

The researchers said that the advised treatment for women with epilepsy who want to have a child includes taking folic acid, beginning before conception and continuing up to the end of the first trimester.

They also said that unless there is no alternative, such women should not be started on the anti-epilepsy drug (AED), valproate, because of its potential to cause foetal abnormalities.

The researchers said it should also be taken into account that polycystic ovary syndrome (PCOS) is observed more frequently in women with epilepsy who are taking this AED.

With PCOS, the ovaries tend to be enlarged with multiple cysts on the surface. The condition is one of the leading causes of infertility in women and symptoms can include irregular periods, hirsutism (excessive growth of body/facial hair) and acne.

Meanwhile, the researchers found that some AEDs may weaken or even abolish the effect of contraceptives. Conversely, oral contraceptives can lower the concentration of anti-epileptic medications.

The team also advised that postmenopausal women on long-term medication for epilepsy should have their bone density measured at regular intervals, because every second woman in this group suffers from AED-associated musculoskeletal problems.

Details of these findings are published in the German medical journal, Deutsches Ärzteblatt International.

For more information on epilepsy, click here

For more information on pregnancy, click here