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Reproductive Aspects of Epilepsy 

Reproductive Aspects of Epilepsy
Reproductive Aspects of Epilepsy

Michael R. Johnson

and John J. Craig

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date: 26 June 2022

Although reproductive aspects should be important for both men and women with epilepsy almost all attention has been concentrated on women, in particular those of child-bearing age. In this chapter we will cover the important reproductive issues that apply to both men and women with epilepsy. However, since it is the management of women with epilepsy of child-bearing age, especially those who contemplate pregnancy, or who become pregnant, that causes most concern, the topics covered in this chapter will tend to focus on the issues relating to the management of women with epilepsy. There are many important topics when considering the reproductive aspects of epilepsy. In this chapter we will discuss the interactions between reproductive hormones and epilepsy, including the effects of epilepsy and antiepileptic drugs (AEDs) on reproductive hormones, the effects of reproductive hormones on epilepsy (catamenial epilepsy) and the interactions between antiepileptic drugs and hormonal contraception. We will also consider teratogenicity and perinatal outcomes, concentrating on the risks for major congenital malformations (MCMs) and the effects of AEDs on cognitive function and behaviour. Lastly, we will consider the relevant management issues in pregnancy and lactation, not forgetting the importance of optimal pre-conceptual counselling.

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