Epilepsy at women - features

Epilepsy at women - features
Epilepsy catameniala
During menstruation, some women recorded an increase in the frequency of epileptic seizures. This is supposed to be due to effects of estrogen and progesterone on neuronal excitability or decrease the serum concentration of antiepileptic drugs as a result of altering transport protein binding. The aid would be increasing the dose of drug control during menstruation and menstrual cycle oral contraceptive.
Pregnancy  
Women with epilepsy do not have complications of pregnancy can be born a normal child. However, because pregnancy affects seizure frequency endocrine effects on the central nervous system: frequency to 50% of women remains unchanged at 30% of cases increases and decreases to 20% of cases. Pregnant women should be monitored more closely during this period.
Frequency of fetal anomalies in infants born to mothers with epilepsy is 5-6%, 2-3% compared with healthy females. The increased incidence is caused by the teratogenic effects of antiepileptic drugs. There are 10% risk of birth defects in the administration of three different drugs. So the ideal is to keep the patient on monotherapy at the lowest effective dose, especially in a quarter. Patients should receive folate 1-4 mg / day to prevent neural tube defects and vitamin K (20 mg / day) in the last month of pregnancy to prevent neonatal bleeding.
Breastfeeding 
 It was observed that anti-epileptic drugs are excreted in human milk. Thus the concentration ratio of drug ethosuximide in front of the milk whey is 80% for phenobarbital is 40-60% for carbamazepine, 40%, 15% for phenytoin and valproic acid 5%. Still nursing the child should not be stopped only when there is an obvious impairment of the infant, such as lethargy.