Examining challenges in caring for women with epilepsy

UCI Health neurologist publishes a guide for epilepsy experts

UCI Health epileptologist Mona Sazgar, MD

Managing epilepsy in women presents neurologists with unique challenges, as the hormonal fluctuations in different stages of life from puberty to pregnancy and menopause may affect seizure control. UCI Health epileptologist Mona Sazgar, MD, has edited Controversies in Caring for Women with Epilepsy to help her peers navigate these issues.

“Seizures and seizure medications may have an effect on a woman’s choice of getting married and starting a family,” said Sazgar, a neurologist in the UCI Health Comprehensive Epilepsy Program. “There is constant worry about the ability to become pregnant, the safety of medications or having a seizure during pregnancy, breastfeeding while on medications and long-term effects of medications on bone health.”

“We would like to offer our patients a single correct answer to all of their questions, but the truth is that there are often several appropriate treatments,” she said.

Sazgar and co-editor Dr. Cynthia Harden seek to provide more clarity by addressing controversial cases related to adolescence, pre-conception, pregnancy and menopause with experts invited to offer their differing views. 

“We looked at various clinical approaches and attempted to build a consensus based on the best available evidence,” Sazgar said. “The goal is to offer treating clinicians with insight on providing the best possible care based on current available data and expert opinion.”

In a unique approach, Sazgar and Harden acted as “flies on the wall” to observe how their peers interact with patients and family. The book is intended for epilepsy neurologists, but Sazgar believes it may be helpful for some patients who have a deep understanding of their disorder.

Sazgar is certified in epilepsy, clinical neurophysiology and neurology by the American Board of Psychiatry & Neurology. The UCI Health Comprehensive Epilepsy Program is a national leader in the diagnosis and delivery of advanced epilepsy care, with the expertise, tools and technology to improve patient’s quality of life. The program holds a Level 4 designation — the highest level — from the National Association of Epilepsy Centers.

“We are one of the few epilepsy centers to specialize in the treatment of women with epilepsy, a diagnosis that affects more than 1.5 million in the United States. We provide comprehensive care to those with epilepsy in all stages of life,” Sazgar said.

The UCI Health Department of Neurology provides clinical care in all areas of neurology and conducts state-of-the-art research to treat and cure neurological conditions, including stroke, epilepsy, brain cancer and movement disorders. In addition, the department manages a robust residency program and trains many of the neurologists who work in Orange County.

UCI Health comprises the clinical, medical education and research enterprises of the University of California, Irvine. Patients can access UCI Health at physician offices throughout Orange County and at its main campus, UC Irvine Medical Center in Orange, Calif., a 411-bed acute care hospital that provides tertiary and quaternary care, ambulatory and specialty medical clinics, behavioral health and rehabilitation. U.S. News & World Report has listed it among America’s Best Hospitals for 15 consecutive years. UC Irvine Medical Center features Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program, Level I trauma center and Level II pediatric trauma center, and is the primary teaching hospital for UC Irvine School of Medicine. UCI Health serves a region of more than 3 million people in Orange County, western Riverside County and southeast Los Angeles County. Follow us on Facebook and Twitter.