Checklist for Working with your Health Care Team

There are many topics that relate to the care of women with epilepsy.

To help you be sure to discuss these topics with your doctors and nurses, here is a checklist, divided into sections appropriate to different life stages. All females, from pre-teen to older women should review the relevant topics with their health care team. 

Background information on these topics can be found in this Women’s Section as well as Professionals. 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 function
  • 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
  • Contraception choices must consider interactions between hormonal contraception & certain AEDs; possible contraceptive failure and need to consider barrier methods or long-acting forms of contraception 
  • Other forms of contraception (patch, IUD, Depo Provera®, progestin implant)
  • Need to inform neurologist if contraception is stopped or changed
  • Need for Vitamin D and calcium for bone health

Women Planning to Conceive or Who Might Become Pregnant in the Future

  • Healthy pregnancies & healthy babies are the goal
  • Know your diagnosis and seizure type
  • Need for the best seizure control possible before pregnancy
  • Know all risks to mother and baby (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; folic acid, healthy lifestyle)
  • Appropriate AED medication and dose - make changes before pregnancy if possible, consult neurologist first, take medications regularly
  • Identify an obstetrician comfortable with treating a woman with epilepsy
  • Need for folate supplementation - if woman is taking any enzyme-inducing drug, folate dose will need to be higher
  • Know how pregnancy can affect seizure frequency & severity
  • Fertility treatments & possible effects on AED levels & seizure

Pregnant Women

  • Know your diagnosis, seizure type, and risks
  • Consultation with obstetrician
  • Learn about the risks of possible birth defects and development in the child
  • Use folic acid and prenatal vitamins
  • Consult a neurologist about possible changes in AED therapy 
  • Need for close monitoring of AED dose and blood level
  • For patients requiring multiple AEDs for seizure control, discussion of choices and risks
  • Possibe Vitamin K for mother before delivery
  • Need for Vitamin K to baby at time of birth
  • Need to bring AEDs to the hospital during labor and to take regular doses
  • AED dose adjustment following delivery and post-partum follow-up
  • Update your Seizure Response Plan for rescue therapies during and after pregnancy
  • Breastfeeding/safety for the newborn
  • Parenting safely for mother and baby's health - adequate sleep, home safety, infant care, safety during seizures 
  • Have ultrasound first and second trimester
  • Newborn appointment for neurologist evaluation (age 4 to 6 weeks)

Women Beyond Childbearing Years

  • Bone health:  need for Vitamin D screening and supplement, calcium or other treatment if needed, bone density monitoring
  • Maximize seizure control and home safety evaluations to prevent falls and injury
  • Peri-menopause effects on seizures/AEDs
  • Menopause/hormone replacement issues; enzyme-inducing effects of hormones on AEDs
Reviewed by: Patricia O. Shafer RN MN | Kimford J. Meador MD on 3/2014
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