Blanca Vazquez, MD
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This document summarizes special considerations for women with epilepsy across the reproductive years, including effects on sexuality, mood, menstruation, fertility, bone health, pregnancy, breastfeeding, and menopause. It discusses how epilepsy and antiepileptic drug use can impact these areas through mechanisms like hormonal changes, drug interactions, teratogenic risks, and bone loss. Management involves counseling, supplementation, contraception guidance, monitoring for side effects, and registry participation for pregnant patients.
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Blanca Vazquez, MD
- 1. Women and Epilepsy Across the Reproductive Years Blanca Vazquez,MD Director of Clinical Trials Comprehensive Epilepsy program NYU Medical Center
- 12. Seizure Frequency in Normal Cycle Average Number of Seizures Per Day Menstrual 0.3 0.4 0.5 0.6 Follicular Ovulatory Luteal * P <0.001 vs. ovulatory or luteal and ovulatory and luteal combined Number of seizures=1324 Number of cycles=98 * * Mean number of seizures/day Herzog AG, et al. Epilepsia. 1997;38:1082-1088.
- 15. Effects of AEDs on Body Weight Gain Neutral Loss Valproate Lamotrigine Topiramate Gabapentin Levetiracetam Zonisamide Carbamazepine Phenytoin Felbamate Tiagabine
- 29. Menopausal Women Epilepsy Pattern Increase Decrease No change Catamenial pattern Percent of women *Significantly associated with a decrease in seizures ( P =0.013) Harden CL, et al. Epilepsia. 1999;40(10):1402-1407. *
Editor's Notes
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- PCOS: National Institutes of Health Diagnostic Criteria. In the United States, PCOS is defined with diagnostic criteria developed by the National Institutes of Health (NIH) as an ovulatory dysfunction with clinical evidence of hyperandrogenism and/or hyperandrogenemia. 3,4 For the condition to be diagnosed, related disorders, such as those that affect adrenal or thyroid function (eg, androgen-secreting neoplasms), must be excluded. 1-3 The diagnosis of PCOS is generally made through a combination of clinical, ultrasonographic, and biochemical criteria. 2 This definition excludes the finding of polycystic ovaries (PCO), multifollicular ovaries, or hyperandrogenism in isolation. Outside of the United States, the diagnosis is usually based on ovarian morphology, and affected women may be further subgrouped by ovulatory status. Because the anovulatory subgroup may demonstrate more profound insulin resistance, differences in diagnostic criteria may explain many of the divergent findings between US and European studies of patients with this disorder. 3 References 1. Bauer J, et al. Epilepsy Res . 2000;41:163-167. 2. Chappell KA, et al. Ann Pharmacother . 1999;33:1211-1216. 3. Dunaif A, et al. Annu Rev Med . 2001;52:401-419. 4. Duncan S. Epilepsia . 2001;42(suppl 3):60-65. Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Clinical Features of PCOS. Hyperandrogenism. Hyperandrogenemia is a key feature of PCOS, and it may appear as hirsutism, acne, male pattern balding, and/or male distribution of body hair. 1 Reference 1. Lobo RA, et al. Ann Intern Med . 2000;132:989-993. Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years
- 2001 Novartis Core T3 Martha J. Morrell M.D. Blanca Vazquez, MD Women's Issues in Epilepsy: Across the Reproductive Years