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Tuesday, August 24, 1999 Published at 15:42 GMT 16:42 UK


'Epileptic women miss vital warnings'

Epilepsy drugs can interfere with a woman's ability to conceive

Epileptic women are frequently not warned that certain drugs could lead to unwanted pregnancies - or even harm their unborn child, says research.

The British Epileptic Association surveyed 6,000 women with the condition, and found that more than half of the 2,000 who replied had not been told by doctors that their anti-convulsive medication could interfere with the contraceptive pill.

The same proportion had not been told about the risks posed by certain drugs to the foetus.

A leading team of epilepsy experts has now drawn up guidance for doctors aimed at improving the care of around 180,000 UK women who have epilepsy.

The key recommendations are that:

  • Every epileptic woman should be counselled on the effect that the condition and treatment can have on contraception, pregnancy and the menopause
  • Women who want to start a family should be free of epileptic seizures wherever possible
  • Therapies should only involve a single drug, rather than combinations of drugs, and changes to treatments should not be made while drug contraception is being used

Dr Tim Betts, clinical director of Birmingham University Seizure Clinic, who helped write the guidelines, said: "This is the first time that the particular needs of women with epilepsy have been targeted so directly.

"Until now, these women might justifiably have complained that their specific medical, social and psychology needs have been somewhat neglected and even marginalised."

Most common serious neurological problem

Around one in 130 people in the UK is affected by active epilepsy - it is 10 times more common than multiple sclerosis and 100 more common than motor neurone disease.

[ image: Women need to be told if there is a risk the Pill will not work]
Women need to be told if there is a risk the Pill will not work
The exact cause of the condition is not known, though brain damage caused by a blow to the head is one possible cause.

Attacks, or seizures, can be brought on by stress, alcohol and certain patterns of light.

The mechanism of the seizure, which can cause the sufferer to black out, suffer convulsions, or perhaps only a partial loss of consciousness, is thought to be driven by subtle changes in the chemistry of the brain, which disrupts electrical messages between cells.

Most women with epilepsy are able to conceive children and have a normal delivery.

But some anti-epileptic medication can reduce the effectiveness of the contraceptive pill, and cause weight gain and fatigue.

Some studies have hinted that certain anti-epilepsy drugs can lead to foetal malformations, such as cleft palates and facial deformities.

It can also interfere with the protection offered by folic acid against spina bifida.

A recent campaign encouraged women diagnosed with the condition to ask their doctor whether their treatment would affect their menstrual cycle, interfere with the Pill, have side-effects, affect their ability to conceive or affect the unborn child.

A spokeswoman for the British Epilepsy Association said: "More often or not people are treated by their GPs, who are not aware of these potential problems.

"There are definite improvements that need to be made."

She said that pre-conception counselling for women with epilepsy was vital, and that women who could not get their questions answered by a GP should ask for a referral to a neurologist.

The British Epilepsy Association runs a helpline offering information on all aspects of the condition on (0808) 8005050.

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