Management issues for women with epilepsy (WWE) are reviewed by a team of investigators in conjunction with the AAN Quality Standards Subcommittee. A literature search reveals the need for outcome studies as a base for practice recommendations on contraception, folate supplements, vitamin K use in pregnancy, breast-feeding, metabolic bone disease, catamenial epilepsy, and reproductive endocrine disorders. [1]
Options recommended by the AAN for WWE that might apply in pediatric neurology practice include use of ethinyl estradiol or mestranol (at least 50 mcg) for women choosing hormonal contraception during treatment with AEDs, and prepregnancy counseling regarding need for folic acid supplements, risks of teratogenic effects of AEDs, and possible withdrawal or change to a safer AED regimen at least 6 months before conception. [2]
COMMENT. For pediatric neurologists who treat adolescents and young adults with epilepsy, these counseling suggestions for WWE are a useful resource.