Women with epilepsy face a variety of unique challenges, particularly with respect to reproductive health. Female hormones can impact brain function and trigger seizures through all life stages, from puberty through menopause. During pregnancy, hormone alterations not only affect seizure activity, but they can alter the metabolism of anti-epileptic drugs.
The Women’s Epilepsy Program at Brigham and Women’s Hospital addresses the very specific needs and concerns of women with epilepsy. The program pulls together an interdisciplinary team that includes neurologists, neurosurgeons, obstetrician gynecologists, neuropsychologists and psychiatrists, all with specialized interest and extensive backgrounds in women’s epilepsy.
All of our epilepsy specialists are well trained in women's issues and can provide consultation or ongoing care. Thomas McElrath, MD, PhD has his research interests in the area of women's issues. This special program was created to provide women with epilepsy with leading-edge neurological and obstetrical clinical care, psychological support, counseling and education based on the latest research on antiepileptic medication use in women with epilepsy during all life stages.
Special Pregnancy Concerns
For women who are contemplating pregnancy or who are pregnant, we offer comprehensive services that begin with choosing the best medication at the right dose to control their seizures and treat their epilepsy, while posing the most minimal risk to the developing baby. This requires a delicate balance that necessitates continued follow-up with our specialized physicians.
Our program provides ongoing monitoring throughout pregnancy and delivery, counseling on all pregnancy and delivery related concerns, from the best vitamin supplementation for preventing neural tube defects to special issues surrounding delivery, breast feeding and motherhood. Brigham and Women’s Hospital is world renowned for the quality of our obstetrical and neonatal care and is dedicated to the most wide-ranging state-of-the-art obstetrical services under one roof in the country.
Perimenopause through Menopause
Hot flashes, hormone replacement therapy and perimenopausal sleep disruptions may all influence seizure patterns. Our specialists help perimenopausal women find the right medication regimen to reduce seizures and the symptoms associated with this life change.
The Women’s Epilepsy Program also serves as an international hub for the latest research studies into the complex interactions between female hormones and the brain, seizure medications, pregnancy and the full range of concerns unique to women, including:
the impact of certain anti-seizure medications on the developing baby during pregnancy and breast feeding;
how anti-seizure medications are metabolized during and after pregnancy;
the impact of increasing levels of estrogen and progesterone during pregnancy on seizure control;
the impact of epilepsy on obstetrical complications;
optimizing prenatal care of women with epilepsy;
cognitive effects of seizure medications on women;
the effects of cycling hormones during the menstrual cycle on seizure control;
use of hormonal treatments to improve seizure control;
the effects of menopause and its treatment on seizure control; and,
epilepsy and headache in women.
Brigham and Women's Hospital is affiliated with the North American Antiepileptic Drug Pregnancy Registry, the largest U.S. research program to date aimed at identifying the safest drugs for pregnant women with epilepsy and their unborn babies.