Forcadas María Isabel, Peña Mayor Pilar, Salas Puig Javier
Department of Neurology, Hospital de Cruces, Biscay, Spain.
Neurologist. 2007 Nov;13(6 Suppl 1):S52-61. doi: 10.1097/NRL.0b013e31815c613d.
The treatment of epilepsy requires special considerations for certain groups of patients. In this review we will address some of these situations, such as epilepsy in women and the elderly.
Epilepsy in women has specific implications, because a significant proportion of women will present epilepsy during reproductive age, affecting contraception, pregnancy, fetal development, and lactation. Moreover, the influence of sex hormones on the evolution of epilepsy is known, as well as the effects of treatment with antiepileptic drugs on fertility, endocrine function and possible adverse effects on weight, to say nothing of cosmetic aspects, sexual function, and bone metabolism. All these factors must be taken into account in the treatment and monitoring of women with epilepsy. The incidence of epilepsy is greater in the elderly than in other population groups and is under diagnosed. The special characteristics of this population, such as the presence of concomitant diseases or greater sensitivity to adverse effects, requires a thorough knowledge of the different options of antiepileptic drugs for each situation.
This article reviews the different types of epilepsy most frequently observed in the elderly, etiology, clinical symptoms, diagnosis, prognosis, and treatment.
癫痫的治疗需要针对特定患者群体进行特殊考量。在本综述中，我们将探讨其中一些情况，例如女性和老年人的癫痫。
女性癫痫具有特定影响，因为相当一部分女性会在育龄期出现癫痫，这会影响避孕、妊娠、胎儿发育和哺乳。此外，已知性激素对癫痫演变的影响，以及抗癫痫药物治疗对生育能力、内分泌功能的影响，还有对体重的可能不良反应，更不用说对容貌、性功能和骨代谢的影响了。在癫痫女性的治疗和监测中必须考虑所有这些因素。老年人癫痫的发病率高于其他人群且诊断不足。该人群的特殊特征，如存在合并症或对不良反应更敏感，需要全面了解每种情况下抗癫痫药物的不同选择。
本文综述了老年人中最常观察到的不同类型癫痫、病因、临床症状、诊断、预后和治疗。
