Taubøll Erik, Gjerstad Leif, Henriksen Tore, Husby Henrik
Nevrologisk avdeling, Rikshospitalet, Oslo.
Tidsskr Nor Laegeforen. 2003 Jun 12;123(12):1691-4.
Women with epilepsy have several gender-specific problems, first of all related to pregnancy and childbirth. They do, however, also meet with several other, less well-recognised specific problems. Many women have a marked change in seizure frequency in relation to their menstrual cycle, and menstrual disorders and polycystic ovaries induced by the use of antiepileptic drugs (AEDs), or by the condition itself, are more frequent in women with epilepsy. Cosmetic side effects of AEDs including weight gain, hair loss and skin problems can significantly reduce compliance in drug treatment and thus affect seizure frequency. Enzyme-inducing AEDs reduce the effectiveness of oral contraceptives and may lead to unplanned pregnancies. A higher incidence of sexual problems in women with epilepsy has also been reported. In menopause, the seizure frequency may change in parallel with the endocrine changes and some AEDs may facilitate the development of osteoporosis. Better understanding and awareness of these problems among patients and health care professionals can relieve many of the gender-specific problems in women. The goal is to tailor the treatment to the needs of the individual woman.
患有癫痫的女性存在一些特定性别的问题,首先与妊娠和分娩有关。然而,她们也会遇到其他一些较少被认识到的特定问题。许多女性的癫痫发作频率与月经周期有明显变化,并且由使用抗癫痫药物(AEDs)或疾病本身引起的月经紊乱和多囊卵巢在癫痫女性中更为常见。AEDs的美容副作用,包括体重增加、脱发和皮肤问题,会显著降低药物治疗的依从性,从而影响癫痫发作频率。诱导酶的AEDs会降低口服避孕药的有效性,并可能导致意外怀孕。也有报道称癫痫女性的性问题发生率较高。在更年期,癫痫发作频率可能会随着内分泌变化而改变,一些AEDs可能会促进骨质疏松症的发展。患者和医护人员对这些问题有更好的理解和认识,可以缓解癫痫女性的许多特定性别问题。目标是根据每位女性的需求定制治疗方案。