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Checklist for Discussions With Your Doctor
Print out this handy checklist (PDF)
There are many topics that relate to the care of women with epilepsy.
To help you be sure to discuss these topics with your doctor, here is a checklist, divided into sections appropriate to different life stages, which pre-teens, teens, young adult women and older women can use as a guide.
This checklist is meant to serve as a reminder of topics you may want to talk with your doctor about. Background medical information can be found in this Women’s Section as well as at (http://professionals.epilepsy.com/page/specpop_women.html). You can click on the PDF version and print it out to take with you to the doctor’s office.
This discussion checklist was developed by the Epilepsy Therapy Project to help women with epilepsy.
FOR ALL WOMEN, ADOLESCENTS, & PRE-TEENS DURING REPRODUCTIVE YEARS
| Relationship between hormones & epilepsy (overview) | |
| Possible menstrual cycle-related influence on seizure (catamenial epilepsy) | |
| Impact of epilepsy on sexual & on reproductive issues | |
| Relationship of epilepsy to fertility | |
| Relation of some seizure medications (AEDs) to sexual desire and fertility | |
| Women with epilepsy CAN become pregnant with or without AEDs; importance of careful pregnancy planning including folate supplementation | |
| Need for effective & consistent form of birth control to avoid unplanned pregnancy | |
| Effective contraception choices (interactions between hormonal contraception & certain AEDs; possible contraceptive failure and need to consider barrier method for added protection) | |
| Other forms of contraception (patch, IUD, Depo Provera®) | |
| Need to inform neurologist if contraception is discontinued | |
| Need for calcium supplementation and vitamin D for bone health |
WOMEN PLANNING TO CONCEIVE
| Healthy pregnancies & healthy babies are the goal | |
| Need for optimum seizure control | |
| All risks (women not taking AEDs also have risks) | |
| Risks to the baby from AEDs must be balanced with risk of seizures to baby & mother | |
| Ways to reduce risks to mother & baby (eg,AED choices; folate supplementation) | |
| Appropriate AED medication/need to optimize before pregnancy; importance of NOT making any changes without neurology consultation (maintaining good compliance) | |
| Identify an obstetrician comfortable with treating a woman with epilepsy | |
| Need for folate supplementation (especially if mother is taking any enzyme-inducing drug) | |
| How pregnancy can affect seizure frequency & severity | |
| Fertility treatments & possible effects on AED levels & seizure susceptibility |
PREGNANT WOMEN
| Consultation with patient’s obstetrician | |
| Possible birth defects associated with AEDs | |
| Possible changes in AED therapy (only in consultation with neurologist) | |
| For patients requiring multiple AEDs for seizure control, discussion of choices, risks, & need for close monitoring of AED dose & blood level | |
| Vitamin K recommendations for mother before delivery & for baby | |
| Need to bring AEDs to the hospital during labor and to take regular doses | |
| AED dose adjustment following delivery and post-partum follow-up | |
| Breastfeeding/safety for the newborn | |
| Newborn appointment for neurologist evaluation (age 4-6 wks) | |
| Parenting issues to maximize safety for the newborn including minimizing mother’s fatigue to avoid seizure exacerbation & home safety preparations | |
| Have ultrasound first and second trimester |
WOMEN BEYOND CHILDBEARING YEARS
| Bone health & need for calcium supplementation & bone density monitoring; seizure control to prevent falls | |
| Peri-menopause effects on seizures/AEDs | |
| Menopause/hormone replacement issues; enzyme-inducing effects of hormones on AEDs |