Khuda Inam, Aljaafari Danah
Department of Neurology, King Fahd Hospital of the University, Imam Abdulrahman bin Faisal University, Al-Khobar, Kingdom of Saudi Arabia. E-mail:
Neurosciences (Riyadh). 2018 Jul;23(3):185-193. doi: 10.17712/nsj.2018.3.20180129.
In the context of local culture and misconceptions regarding epilepsy, Saudi practitioners need a careful management plan for women with epilepsy that satisfies all the patients needs and ensures their spouses understanding. Such a management strategy needs to incorporate careful selection and monitoring of anti-epileptic drugs and regular counseling of patients. Female epileptic patients in the reproductive age group, no matter whether they are pregnant or not, should be managed by safest drugs from the earliest with folic acid supplementation along with adequate pre-marriage/conception counseling. All antiepileptic drugs are potentially teratogenic. However, valproic acid, phenytoin, phenobarbitone, and topiramate are least favored for use. Monotherapy is preferred over polytherapy, and the least possible dose should be used. During pregnancy, many epileptic women may need monthly drug level monitoring and dose readjustments. Normal vaginal delivery is safe in epileptic women. Post-partum follow-up with anti-epileptic drug titration may be required.
在沙特当地文化以及对癫痫存在误解的背景下，沙特的从业者需要为癫痫女性制定一个细致的管理计划，以满足所有患者的需求并确保其配偶的理解。这样的管理策略需要包括对抗癫痫药物的谨慎选择和监测以及对患者的定期咨询。处于育龄期的女性癫痫患者，无论是否怀孕，都应尽早使用最安全的药物，并补充叶酸，同时提供充分的婚前/孕前咨询。所有抗癫痫药物都有潜在的致畸性。然而，丙戊酸、苯妥英、苯巴比妥和托吡酯是最不适合使用的。单药治疗优于联合治疗，应使用尽可能低的剂量。在怀孕期间，许多癫痫女性可能需要每月监测药物水平并调整剂量。癫痫女性进行正常阴道分娩是安全的。产后可能需要进行抗癫痫药物滴定的随访。
