Conclusion
Best management of the woman with epilepsy considers seizure control as well as overall well-being. The health care provider aware of hormone effects on seizures is in the best position to respond to changes in seizures at puberty, over the menstrual cycle, and at menopause. Similarly, care is enhanced when the provider recognizes the potential for some AEDs to interfere with hormone-based oral contraception, is alert to signs and symptoms of reproductive health dysfunction, is proactive about maintaining bone health, and is able to provide accurate preconceptional counseling and close monitoring during pregnancy. Ultimately, best care of women with epilepsy will improve as new data emerge regarding epilepsy and AED effects on endocrine and metabolic physiology and as information emerges from pregnancy registries and ongoing studies of fetal outcome. Some day, women with seizures will be offered not only seizure control but also a life otherwise unaffected by epilepsy.
CME Information
The print version of this article was originally certified for CME credit. For accreditation details, contact Division of Continuing Medical Education, Indiana University School of Medicine, 714 N. Senate Avenue, EF 200, Indianapolis, IN 46202 (317) 274-4220, (800) 622-4989.
Address for correspondence and reprint requests: Alison M. Pack, MD, Department of Neurology, The Neurological Institute, 710 West 168th Street, New York, NY 10032.
Semin Neurol. 2002;22(3) © 2002 Thieme Medical Publishers
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