Abstract Details

Title Relative Risks of Changes in Seizure Frequency with Hormonal Versus Non-Hormonal Contraception

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) S08 - (-)

Poster/Presentation
Number 005

Objective

Background Some reproductive steroids have neuroactive properties that affect neuronal excitability and seizure thresholds but little is known about the consequences of HC on seizures in WWE in the community.

Design/Methods The Epilepsy Birth Control Registry is a web-based survey that gathers demographic, epilepsy, AED, contraceptive and reproductive data from WWE in the community. These retrospective data come from 1057 contraceptive experiences reported by the first 500 WWE, ages 18-47 years, who completed the survey. We determined relative risks (RRs) of reported increase and decrease in seizure frequency on HC (combined or progestin pills, depomedroxyprogesterone, hormonal patch, implanted hormones, vaginal ring) versus non-HC (withdrawal, male and female condom, copper and progestin IUD, tubal ligation), including analysis by categories (withdrawal, barrier, hormonal [oral, non-oral, combined, progestin-only], IUD and tubal ligation).

Results RR for increased seizures on HC (20.9%) versus non-HC (2.6%) was 8.0 [95% CI = 4.7-13.6], p <.0001. There was no significant difference in RR for seizure increase with combined (21.7%) versus progestin-only (23.7%) contraception. RR for seizure increase with non-oral combined HC (30.4%) versus oral combined contraceptives (18.3%) was 1.7 [1.1-2.5], p = .01. There was no significant difference in RR for seizure increase with non-oral progestin-only HC (21.1%) versus oral progestin-only HC (20.0%). RR for seizure decrease on HC (9.2%) versus non-HC (5.7%) was 1.6 [1.1-2.5], p = .03. The only significant comparison by specific categories was depomedroxyprogesterone (14.6%) versus all combined contraceptives (7.6%): RR = 1.9 [1.0-3.6], p = .04.

Conclusions Retrospective survey findings suggest that RR for seizure increase is greater with HC than non-HC. RR is greater with non-oral than oral combined HC. RR for seizure decrease is greater with depomedroxyprogesterone than with combined HC.

Authors/Disclosures
Hannah Mandle PRESENTER	No disclosure on file
	No disclosure on file
Kristen Fowler (Beth Israel Deaconess Medical Center)	No disclosure on file
Anne R. Davis, MD (Columbia University Medical Center)	Dr. Davis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Exeltis. Dr. Davis has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mylan . Dr. Davis has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for ACLU. Dr. Davis has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Planned Parenthood Federation of America .
W. A. Hauser, MD, FAAN (Columbia University)	No disclosure on file
Andrew G. Herzog, MD, MSc, FAAN	Dr. Herzog has nothing to disclose.
Evanthia Bernitsas, MD, FAAN (Wayne State School of Medicine)	Dr. Bernitsas has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen@Janssen. Dr. Bernitsas has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen. The institution of Dr. Bernitsas has received research support from Roche/Genentech.

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