Epilepsy: take care of the women’s beauty from childhood

The report considers an important issues of the course and treatment of epilepsy in women. Specific aspects of the problem are noted, the basic principles and features of the treatment of female epilepsy are shown, the problems of pregnancy planning are discussed.

Anxiety and depressive disorders associated with epilepsy in women of reproductive age

Background: Mental disorders in people with epilepsy are an old problem that remains crucial nowadays. The specialized literature has reported increasingly significant values of anxiety and depressive disorders associated with epilepsy in women during their child bearing age. The prevalence of depression comorbidity related to epilepsy has accounted for 55% of cases, many of which remain undiagnosed. Anxiety exceeds the frequency of depressive cases by 10-15%, which tends to be milder, however showing a chronic evolution. It is important to find out the correlation between the occurrences of mental disorder in women with epilepsy from the Republic of Moldova. The purpose of the study was to assess the depressive and anxiety symptoms associated with epilepsy in women of reproductive age. Material and methods: A retrospective cohort study was conducted on a group of 128 women with epilepsy. Patients were divided into 2 groups, with anxiety and depression respectively. Hospital and Anxiety Depression Scale (HADS) was applied for estimating anxiety and depression, being considered a priority compared to Hamilton scales, the Beck Inventory, the Zung scale. Results: It has been proved that the disease duration and seizure recurrence are directly proportional to prevalence of depression and anxiety cases. The type of seizure remains a controversial topic. Conclusions: Anxiety and depression in epilepsy patients show a heterogeneous nature due to clinical pleiomorphism. The HAD scale is effective for the early diagnosis of anxiety and depression in epilepsy women.

Current trends in epileptology: priorities, challenges, tasks and solutions

Within a field meeting of experts from the Russian branch of the League Against Epilepsy (RLAE), diagnostic and treatment aspects of epilepsy were discussed with the emphasis on the female population (girls, women of childbearing and older ages). All experts underscored the special features and unique needs of female patients with epilepsy. Experimental and clinical studies on efficacy and safety of traditional and novel antiepileptic drugs (AEDs) applied to women with epilepsy were discussed. It was commonly agreed that the new generation of AEDs did not yet find an appropriate place in the clinical practice, and that they were mainly used as add-on therapy in order to overcome drug resistance. The current use of AEDs in the treatment of epilepsy is, by large, not gender-specific and is not related enough to age, sociodemographic characteristics, and comorbid disorders. It should be noted that the new AEDs are addressed specifically to individual, socio-demographic, gender and clinical features of the patient. The potential of some AEDs (lamotrigine), in fact, remains underestimated by practitioners. Due to the current restrictions in using valproic acid, lamotrigine is the alternative medication for women with epilepsy. Having a balanced profile of efficacy and safety, lamotrigine is recommended as the first choice drug for initial therapy, as well as an alternative monotherapy for epilepsy in women.These data were presented at the Russian League Against Epilepsy (RLAE) on-site meeting “Epilepsy and Woman” 18 September 2019 (Ohrid, Makedonia).

Progesterone in Treatment of Catamenial Epilepsy

Catamenial epilepsy refers to the temporal correlation of seizure exacerbations with the menstrual cycle. Changes in the serum estradiol and progesterone are implicated in this phenomenon, which makes management of epilepsy in women more challenging. This is a case of a 24-year-old nulligravid who was referred to a reproductive medicine specialist due to refractory focal seizures despite antiepileptic pharmacotherapy. EEG confirmed neurologic dysfunction but clinical history, physical examination, cranial CT and MRI ruled out structural, vascular, traumatic, and infectious causes of seizure. Adjunctive hormonal treatment was given, which improved patient symptoms. This report aims to discuss catamenial epilepsy as to its pathophysiology, diagnosis, and management. Better understanding of this disease entity will help address treatment difficulties in epilepsy in female patients and the associated management issues.