Date of Award
Spring 2023
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
Sophie Farley, MMS, PA-C
Abstract
JAE is an epilepsy syndrome that typically requires lifelong AED treatment, and valproic acid or lamotrigine is considered first line to manage the spectrum of associated seizures. In females with JAE who become pregnant, there exist risks both from having uncontrolled seizures and from taking AEDs during the pregnancy. Valproic acid carries the highest risks to the fetus but is the most effective in controlling the seizure types seen with JAE. Folic acid supplementation has shown to mitigate some but not all of the fetal risks from valproic acid. Limited guidance from professional organizations exists for management of females of childbearing age and pregnant females with JAE. Adequate counseling should be provided to all females of childbearing age with JAE regarding pregnancy, contraceptives, folic acid supplementation, and the risks and benefits of different AEDs. A shared decision-making approach should be used to optimize outcomes for these patients.
Recommended Citation
Brew, Casey, "Considerations in the Management of Juvenile Absence Epilepsy in Pregnancy and in Females of Childbearing Age" (2023). Capstone Showcase. 2.
https://scholarworks.arcadia.edu/showcase/2023/pa/2
Included in
Considerations in the Management of Juvenile Absence Epilepsy in Pregnancy and in Females of Childbearing Age
JAE is an epilepsy syndrome that typically requires lifelong AED treatment, and valproic acid or lamotrigine is considered first line to manage the spectrum of associated seizures. In females with JAE who become pregnant, there exist risks both from having uncontrolled seizures and from taking AEDs during the pregnancy. Valproic acid carries the highest risks to the fetus but is the most effective in controlling the seizure types seen with JAE. Folic acid supplementation has shown to mitigate some but not all of the fetal risks from valproic acid. Limited guidance from professional organizations exists for management of females of childbearing age and pregnant females with JAE. Adequate counseling should be provided to all females of childbearing age with JAE regarding pregnancy, contraceptives, folic acid supplementation, and the risks and benefits of different AEDs. A shared decision-making approach should be used to optimize outcomes for these patients.