Preface

This book began with a simple desire to create a practical, portable tool to help busy practitioners care forwomen with epilepsy. It was developed for neurologists, internists, obstetricians and gynecologists, family physicians, anesthetists, midwives, nurses, social workers, pharmacists, neonatologists, and all those who care for women with epilepsy. The diversity of our audience reflects the inherent multidisciplinary nature of this practice. Caring for women with epilepsy, especially during pregnancy, has challenges that many of us frequently feel ill-equipped to manage.Questions such as: How do hormones influence seizures, and how is this best managed? What is the teratogenicity of newerdrugs such as topiramate or levetiracetam? What is the best form of birth control to use in women with epilepsy? How do I give my patient the best chance of seizure freedom during pregnancy? What factors can predict seizures in pregnancy? How do I manage seizures or status epilepticus in pregnancy especially during labor and delivery? Do hormone replacement therapies pose a risk for seizure exacerbation? I still recall the many sleepless nights ruminating over whether I was providing the best possible care for these women. This culminated when a young pregnant patient of mine with epilepsy deteriorated into status epilepticus. The challenges of this, and many other cases, have catalyzed for me a strong desire to summarize key and critical concepts in the care of these women. I am grateful to have worked with world experts on these topics. They have successfully distilled key practice points and provided comprehensive basic science data, pregnancy registry data, and expert opinion to further enrich our understanding and ability to counsel patients. This book is designed as a quick, accessible, everyday, easy-to-use manual that puts the essentials of caring for women with epilepsy at one’s fingertips.