Treatment of Women With Epilepsy

Mona Sazgar, MD, FAES Epilepsy p. 408-430 April 2019, Vol.25, No.2 doi: 10.1212/CON.0000000000000713
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PURPOSE OF REVIEW: This article provides the latest information to guide practitioners in counseling and treating women with epilepsy.

RECENT FINDINGS: There is an increasing body of literature on the multidirectional effects of sex hormones on seizure frequency and severity and of seizures altering areas of the brain involved in neuroendocrine function. Ongoing pregnancy outcome data from pregnancy registries and meta-analysis of observational studies have provided key information on the safety of using antiseizure medications during pregnancy and the risk to the fetus.

SUMMARY: In treating and counseling women with epilepsy from puberty to menopause, it is important to understand the complex interactions of sex hormones, seizures, and antiseizure medications on reproductive health and pregnancy outcomes.

Address correspondence to Dr Mona Sazgar, Department of Neurology, University of California Irvine Health, Comprehensive Epilepsy Program, 101 The City Dr S, Pavilion I, Ste 123, Orange, CA 92868-3201,

RELATIONSHIP DISCLOSURE: Dr Sazgar has received personal compensation for serving on the scientific advisory board for UCB SA and for serving on the speaker’s bureau of Eisai Co, Ltd; Sunovion Pharmaceuticals Inc; and UCB SA. Dr Sazgar has received grants or research support from Biogen, Sunovion Pharmaceuticals Inc, and UCB SA as the principal investigator for clinical trials and has received publishing royalties from Springer for her book Controversies in Caring for Women with Epilepsy.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Sazgar discusses the unlabeled/investigational use of acetazolamide, clobazam, depot-medroxyprogesterone acetate, and progesterone products for the treatment of women with catamenial epilepsy.

© 2019 American Academy of Neurology