J Korean Med Assoc.  2003 Apr;46(4):315-325. 10.5124/jkma.2003.46.4.315.

Epilepsy : Special Populations

• Song HK

• KMID: 2065113
• DOI: http://doi.org/10.5124/jkma.2003.46.4.315

Abstract

In this chapter, epilepsy or seizure in special populations or conditions, pregnant women or those who are planning to be pregnant elderly individuals, patients with a systemic disease, and mentally retarded subjects are discussed. Pregnancy in pregnant woman is associated with increased obstetric risks and increased adverse neonatal outcomes. Effective control of maternal seizures with the least risk to the fetus is the goal. Careful planning and management of any pregnancy are essential to increase likelihood of a healthy outcome both for the mother and the baby. Some guidelines for woman with epilepsy will be introduced. The elderly are the most rapidly growing part of our population, and the prevalence of epilepsy is also rapidly increasing in this group. Age-related physiologic changes in hepatic and renal function, volume of distribution, and exaggerated sensitivity to side effects should de considered. The elderly with a systemic disease such as cardiovascular disorder and renal and hepatic failure require a more complex approach. Epilepsy is a common occurrence in individuals with mental retardation. The degree of mental retardation, associated behavioral disorders, and the type of epilepsy or epileptic syndrome can affect the treatment modality and prognosis. The treatments should be tailored to the needs of individual patients. Comprehensive management requires the involvement of an interdisciplinary team to enhance functioning and achieve optimal quality of care.

Keyword

Epilepsy; Pregnancy; Elderly; Systemic disease; Mental retardation

MeSH Terms

Aged
Epilepsy*
Female
Fetus
Humans
Intellectual Disability
Liver Failure
Mentally Disabled Persons
Mothers
Pregnancy
Pregnant Women
Prevalence
Prognosis
Seizures

Reference

2. Pennell PB. Pregnancy in the woman with epilepsy: maternal and fetal outcomes. Semin Neurol. 2002. 22(3):299–308.

3. Pack AM, Morrell MJ. Treatment of women with epilepsy. Semin Neurol. 2002. 22:289–298.

4. Zahn CA, Morrell MJ, Collins SD, Labiner DM, Yerby MS. Management issues for women with epilepsy. Neurology. 1998. 51:949–956.

5. Morrell MJ. Guidelines for the care of women with epilepsy. Neurology. 1998. 51:5 Suppl 4. S21–S27.

6. Yerby M. Pregnancy, Teratogenesis and epilepsy. Neurol Clin. 1994. 12:749–771.

7. Delgado-Escueta AV, Janz D. Consensus guidelines: preconception counseling, management, and care of the pregnant woman with epilepsy. Neurology. 1992. 42:4 Suppl 5. 149–160.

8. Leppik IE, Birnbaum A. Epilepsy in the elderly. Semin Neurol. 2002. 22(3):309–320.

9. Boggs JG. Elderly patients with systemic disease. Epilepsia. 2001. 42:Suppl 8. 18–23.

10. Gareri P, Gravina T, Ferreri G, De Sarro G. Treatment of epilepsy in the elderly. Progress in Neurobiology. 1999. 58:389–407.

11. Rowan AJ. Reflections on the treatment of seizures in the elderly population. Neurology. 1998. 51:5 Suppl 4. S28–S33.

12. Bolton CF, Young GB. Neurologic complications of renal disease. Batterworths, Boston, 1990. Dreifuss FE. Anticonvulsant agents. Crit Care Clin. 1991. 7:521–532.

13. Futrell N, Schultz LR, Milikan C. Central nervous system disease in patients with systemic lupus erythematosus. Neurology. 1992. 42:1649–1657.

14. Sibley JT, Olszynski WP, Decoteau WE, Sundaram MG. The incidence and prognosis of central nervous system disease in systemic lupus erythematosus. J Rheumatol. 1992. 19:47–52.

15. Bleck TP, Smith MC. Possible induction of systemic lupus erythematosus by valproate. Epilepsia. 1990. 31:343–345.

16. Coulter DL. Comprehensive management of epilepsy in persons with mental retardation. Epilepsia. 1997. 38:Suppl 4. s24–s31.

17. Working group of the International Association of the Scientific Study of Intellectual Disability. Clinical guidelines for the management of epilepsy in adults with an intellectual disability. Seizure. 2001. 10(6):401–409.

18. Steffenburg U, Hedstrom A, Lindroth A, Wiklund LM, Hagberg G, Kyllerman M. Intractable epilepsy in a population-based series of mentally retarded children. Epilepsia. 1998. 39(7):767–775.

19. Coulter DL. Epilepsy and mental retardation: an overview. Am J Ment Retard. 1993. 98:Suppl. 1–11.

20. Besag FM. Childhood epilepsy in relation to mental handicap and behavioural disorders. J Child Psychol Psychiatry. 2002. 43(1):103–131.

21. Vasconcellos E, Wyllie E, Sullivan S, Stanford L, Bulacio J, Bingaman W, et al. Mental retardation in pediatric candidates for epilepsy surgery: the role of early seizure onset. Epilepsia. 2001. 42(2):268–274.

22. Forsgren L, Edvinsson SO, Nystrom L, Blomquist HK. Influence of epilepsy on mortality in mental retardation: an epidemiologic study. Epilepsia. 1996. 37(10):956–963.