中国临床药理学与治疗学 ›› 2026, Vol. 31 ›› Issue (2): 162-167.doi: 10.12092/j.issn.1009-2501.2026.02.003
收稿日期:2025-05-27
修回日期:2025-09-15
出版日期:2026-02-26
发布日期:2026-03-17
通讯作者:
赵忠新
E-mail:zhaozhengqing83@hotmail.com;neuzhaozx@163.com
作者简介:赵正卿,女,博士, 副主任医师,研究方向:睡眠障碍、癫痫、肌张力障碍。E-mail:基金资助:
Zhengqing ZHAO(
), Yanpeng LI, Zhongxin ZHAO(
)
Received:2025-05-27
Revised:2025-09-15
Online:2026-02-26
Published:2026-03-17
Contact:
Zhongxin ZHAO
E-mail:zhaozhengqing83@hotmail.com;neuzhaozx@163.com
摘要:
女性癫痫患者相对男性癫痫患者而言,受激素水平变化、生理周期、生育需求等因素影响,其临床特点具有一定的特殊性,在选择抗癫痫发作药物时需兼顾疗效和安全性,存在一定的挑战性。本文重点分析了处于不同生理时期的女性癫痫患者的不同临床特点,并就女性癫痫患者在不同时期的药物治疗选择以及治疗的新进展进行综述和展望。
中图分类号:
赵正卿, 李雁鹏, 赵忠新. 女性癫痫患者的临床特点和药物治疗研究进展[J]. 中国临床药理学与治疗学, 2026, 31(2): 162-167.
Zhengqing ZHAO, Yanpeng LI, Zhongxin ZHAO. Clinical characteristics and medicine treatment progress in female patients with epilepsy[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(2): 162-167.
| 1 |
Velez-Ruiz NJ, Pennell PB. Issues for women with epilepsy[J]. Neurol Clin, 2016, 34 (2): 411- 425.
doi: 10.1016/j.ncl.2015.11.009 |
| 2 |
TaubOll E, Sveberg L, Svalheim S. Interactions between hormones and epilepsy[J]. Seizure, 2015, 28, 3- 11.
doi: 10.1016/j.seizure.2015.02.012 |
| 3 | Razaz N, Tomson T, Wilkstrom AK, et al. Association between pregnancy and perinatal outcomes among women with epilepsy[J]. JAMA Neurol, 2017, 74 (8): 983- 991. |
| 4 |
Fiest KM, Sauro KM, Wiebe S, et al. Prevalence and incidence of epilepsy: a systematic review and meta-analysis of international studies[J]. Neurology, 2017, 88 (3): 296- 303.
doi: 10.1212/WNL.0000000000003509 |
| 5 |
Kolomar H, Osman A, Blanco LVA, et al. A comprehensive review on the influence of menstrual cycle and pregnancy on epileptic seizures[J]. Cureus, 2025, 17 (3): e80387.
doi: 10.7759/cureus.80387 |
| 6 |
Scharfman HE, MacLusky NJ. The influence of gonadal hormones on neuronal excitability, seizures, and epilepsy in the female[J]. Epilepsia, 2006, 47 (9): 1423- 1440.
doi: 10.1111/j.1528-1167.2006.00672.x |
| 7 | Taubøll E , Isojärvi JIT, Herzog AG. The interactions between reproductive hormones and epilepsy [J]. Handb Clin Neurol, 2021, 182: 155-174. |
| 8 | Voinescu PE, Park S, Chen LQ, et al. Antiepileptic drug clearances during pregnancy and clinical implications for women with epilepsy [J]. Neurology, 2018, 91(13): e1228-e1236. |
| 9 |
Mirawati DK, Wiyono N, Ilyas MF, et al. Research productivity in catamenial epilepsy: a bibliometric analysis of worldwide scientific literature (1956-2022)[J]. Heliyon, 2024, 10 (10): e31474.
doi: 10.1016/j.heliyon.2024.e31474 |
| 10 |
Carosella CM, Johnson EL. Special issues in medical management: hormones and pregnancy in epilepsy[J]. Semin Neurol, 2025, 45 (2): 198- 205.
doi: 10.1055/a-2551-0688 |
| 11 | Hessler A, Dolbec K. Seizures: updates in women's health care primary and preventive care review[J]. Obstet Gynecol, 2021, 137 (1): 207. |
| 12 |
Li YX, Guo W, Chen RX, et al. The relationships between obesity and epilepsy: a systematic review with meta-analysis[J]. PLoS One, 2024, 19 (8): e0306175.
doi: 10.1371/journal.pone.0306175 |
| 13 |
Josephson CB, Gonzalez-Izquierdo A, Denaxas S, et al. Independent associations of incident epilepsy and enzyme-inducing and non-enzyme-inducing antiseizure medications with the development of osteoporosis[J]. JAMA Neurol, 2023, 80 (8): 843- 850.
doi: 10.1001/jamaneurol.2023.1580 |
| 14 |
Qin SK, Yang ZX, Guan ZW, et al. Exploring the association between epilepsy and depression: a systematic review and meta-analysis[J]. PLoS One, 2022, 17 (12): e0278907.
doi: 10.1371/journal.pone.0278907 |
| 15 |
Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the international league against epilepsy: Position paper of the ILAE commission for classification and terminology[J]. Epilepsia, 2017, 58 (4): 522- 530.
doi: 10.1111/epi.13670 |
| 16 |
Maguire MJ, Nevitt SJ. Treatments for seizures in catamenial (menstrual-related) epilepsy[J]. Cochrane Database Syst Rev, 2021, 9 (9): CD013225.
doi: 10.1002/14651858.cd013225.pub2 |
| 17 |
Nucera B, Rinaldi F, Dono F, et al. Progesterone and its derivatives for the treatment of catamenial epilepsy: a systematic review[J]. Seizure, 2023, 109 (7): 52- 59.
doi: 10.1016/j.seizure.2023.05.004 |
| 18 |
Joshi S, Sun H, Rajasekaran K, et al. A novel therapeutic approach for treatment of catamenial epilepsy[J]. Neurobiol Dis, 2018, 111, 127- 137.
doi: 10.1016/j.nbd.2017.12.009 |
| 19 |
Shiono S, Williamson J, Kapur J, et al. Progesterone receptor activation regulates seizure susceptibility[J]. Ann Clin Transl Neurol, 2019, 6 (7): 1302- 1310.
doi: 10.1002/acn3.50830 |
| 20 |
中华医学会神经病学分会脑电图与癫痫学组. 中国围妊娠期女性癫痫患者管理指南[J]. 中华神经科杂志, 2021, 54 (6): 539- 544.
doi: 10.3760/cma.j.cn113694-20201116-00879 |
| 21 | Tomson T, Battino D, Bonizzoni E, et al. Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry [J]. Lancet Neurol, 2018, 17(6): 530-538. |
| 22 | Hernandez-Diaz S, Smith CR, Shen A, et al. Comparative safety of antiepileptic drugs during pregnancy [J]. Neurology, 2012, 78(21): 1692-1699. |
| 23 | Tomson T, Battino D, Bonizzoni E, et al. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry [J]. Lancet Neurol, 2011, 10(7): 609-617. |
| 24 |
Weston J, Bromley R, Jackson CF, et al. Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child[J]. Cochrane Database Syst Rev, 2016, 11 (11): CD010224.
doi: 10.1002/14651858.cd010224.pub2 |
| 25 |
Karanam A, Pennell PB, Meador KJ, et al. Characterization of lamotrigine disposition changes during and after pregnancy in women with epilepsy[J]. Pharmacotherapy, 2025, 45 (1): 33- 42.
doi: 10.1002/phar.4640 |
| 26 | Molgaard-Nielsen D, Hviid A. Newer-generation antiepileptic drugs and the risk of major birth defects [J]. JAMA, 2011, 305(19): 1996-2002. |
| 27 | Tomson T, Battino D, Bonizzoni E, et al. Declining malformation rates with changed antiepileptic drug prescribing: an observational study [J]. Neurology, 2019, 93(9): e831-e840. |
| 28 | Cohen MJ, Meador KJ, May R, et al. Fetal antiepileptic drug exposure and learning and memory functioning at 6 years of age: The NEAD prospective observational study [J]. Epilepsy Behav, 2019, 92: 154-164. |
| 29 | Adab N, Kini U, Vinten J, et al. The longer term outcome of children born to mothers with epilepsy [J]. J Neurol Neurosurg Psychiatry, 2004, 75(11): 1575-1583. |
| 30 | Reisinger TL, Newman M, Loring DW, et al. Antiepileptic drug clearance and seizure frequency during pregnancy in women with epilepsy [J]. Epilepsy Behav, 2013, 29(1): 13-18. |
| 31 | Tomson T, Landmark CJ, Battino D. Antiepileptic drug treatment in pregnancy: changes in drug disposition and their clinical implications [J]. Epilepsia, 2013, 54(3): 405-414. |
| 32 | Birnbaum AK, Meador KJ, Karanam A, et al. Antiepileptic drug exposure in infants of breastfeeding mothers with epilepsy [J]. JAMA Neurol, 2020, 77(4): 441-450. |
| 33 | Meador KJ, Baker GA, Browning N, et al. Breastfeeding in children of women taking antiepileptic drugs: cognitive outcomes at age 6 years[J]. JAMA Pediatr, 2014, 168 (8): 729- 736. |
| 34 |
Sourbron J, Auvin S, Cabral-Lim L, et al. Vitamin D prophylaxis in persons with epilepsy?[J]. Epilepsia, 2024, 65 (9): 2567- 2579.
doi: 10.1111/epi.18046 |
| 35 |
Uçan Tokuç FE, Fatma G, Abidin E, et al. Management of bone metabolism in epilepsy[J]. Ideggyogy Sz, 2021, 74 (7/8): 257- 265.
doi: 10.18071/isz.74.0257 |
| 36 |
Lambrinoudaki I, Kaparos G, Armeni E, et al. BsmI vitamin D receptor's polymorphism and bone mineral density in men and premenopausal women on long-term antiepileptic therapy[J]. Eur J Neurol, 2011, 18 (1): 93- 98.
doi: 10.1111/j.1468-1331.2010.03103.x |
| 37 |
Carvalho V, Colonna I, Curia G, et al. Sex steroid hormones and epilepsy: effects of hormonal replacement therapy on seizure frequency of postmenopausal women with epilepsy-A systematic review[J]. Eur J Neurol, 2023, 30 (9): 2884- 2898.
doi: 10.1111/ene.15916 |
| 38 |
Yamamoto Y, Akita N, Nogimoto H, et al. Changes in perampanel pharmacokinetics and cytochrome P450 3A4 activity before, during, and after pregnancy[J]. Ther Drug Monit, 2024, 46 (4): 548- 551.
doi: 10.1097/FTD.0000000000001195 |
| 39 |
Hoeltzenbein M, Slimi S, Fietz AK, et al. Increasing use of newer antiseizure medication during pregnancy: an observational study with special focus on lacosamide[J]. Seizure, 2023, 107, 107- 113.
doi: 10.1016/j.seizure.2023.02.015 |
| 40 |
Vazquez B, Tomson T, Dobrinsky C, et al. Perampanel and pregnancy[J]. Epilepsia, 2021, 62 (3): 698- 708.
doi: 10.1111/epi.16821 |
| 41 |
Barry JM, Illamola SM, Pennell PB, et al. Prediction of lacosamide concentrations to support dose optimization during pregnancy[J]. Epilepsia, 2025, 66 (2): 346- 355.
doi: 10.1111/epi.18184 |
| 42 |
Pennell PB, Karanam A, Meador KJ, et al. Antiseizure medication concentrations during pregnancy: results from the maternal outcomes and neurodevelopmental effects of antiepileptic drugs (MONEAD) study[J]. JAMA Neurol, 2022, 79 (4): 370- 379.
doi: 10.1001/jamaneurol.2021.5487 |
| 43 |
Navarro CE. A healthy outcome of a pregnant woman with drug-resistant juvenile myoclonic epilepsy treated with brivaracetam[J]. Neurol Sci, 2023, 44 (2): 753- 755.
doi: 10.1007/s10072-022-06444-7 |
| 44 |
Clayton LM, Vakrinou A, Balestrini S, et al. Monogenic epilepsies in adult epilepsy clinics and gene-driven approaches to treatment[J]. Curr Neurol Neurosci Rep, 2025, 25 (1): 35.
doi: 10.1007/s11910-025-01413-x |
| [1] | 翟菲菲, 黄颜. 睡眠相关过度运动性癫痫诊疗进展[J]. 中国临床药理学与治疗学, 2026, 31(2): 168-174. |
| [2] | 郑韵熹, 易晓芳, 徐丛剑. 非肽类促性腺激素释放激素拮抗剂在子宫肌瘤治疗中的应用研究进展[J]. 中国临床药理学与治疗学, 2024, 29(5): 482-487. |
| [3] | 朱诚程, 罗永红, 丁锦, 程慧娴, 倪观太. 经脐无气腹单孔腔镜联合罗哌卡因局部浸润麻醉在妊娠合并卵巢肿瘤中的应用[J]. 中国临床药理学与治疗学, 2024, 29(5): 561-568. |
| [4] | 王小川, 王汉超, 姚宇, 李丽, 何高燕, 李博, 朱涛. 慢性阻塞性肺疾病急性加重期合并2型糖尿病患者的临床特征和危险因素分析与治疗[J]. 中国临床药理学与治疗学, 2024, 29(4): 392-400. |
| [5] | 张立仪, 郭紫芬. 孕激素治疗子宫内膜癌研究进展[J]. 中国临床药理学与治疗学, 2024, 29(2): 230-235. |
| [6] | 李志敏, 李诗然, 谢婧娴, 张 娇, 李鹏飞, 曾思羽, 杨勇. 妊娠合并高甘油三酯血症诊治和管理研究进展[J]. 中国临床药理学与治疗学, 2024, 29(12): 1380-1388. |
| [7] | 周小诗, 李诗然, 曾思羽, 李果霖, 张昌吉, 杨勇. 生物制剂在妊娠合并风湿免疫性疾病中的应用进展[J]. 中国临床药理学与治疗学, 2024, 29(12): 1389-1400. |
| [8] | 段淑文, 魏亚君, 武天凯, 王晓辉, 丁照然, 刘灿, 戴恩来. 基于NLRP3/Caspase-1/GSDMD通路对泼尼松联合淫羊藿苷提高激素抵抗型肾病综合征疗效的机制研究[J]. 中国临床药理学与治疗学, 2024, 29(10): 1081-1090. |
| [9] | 张胡云龙, 朱秀之, 金 希, 邵志敏. 腔面型乳腺癌内分泌治疗耐药的机制与治疗进展[J]. 中国临床药理学与治疗学, 2023, 28(8): 854-865. |
| [10] | 胡康一, 曹林忠, 万超超, 尚征亚, 杨小瑞, 张勇杰. 基于线粒体功能障碍探讨中药防治激素性股骨头坏死的基础研究进展[J]. 中国临床药理学与治疗学, 2023, 28(6): 688-696. |
| [11] | 朱 丽, 魏 兵, 廖世峨, 张 超, 郑晓宇, 刘亚军. 药物代谢酶细胞色素P450单核苷酸多态性影响哮喘儿童吸入皮质醇激素疗效研究[J]. 中国临床药理学与治疗学, 2023, 28(5): 536-543. |
| [12] | 周晶, 周琛, 廖珂, 邱爱林, 董巍檑, 郭紫芬. 孕激素受体基因G1978T 多态性与子宫内膜癌的相关性研究[J]. 中国临床药理学与治疗学, 2023, 28(4): 400-406. |
| [13] | 曹放, 覃开蓉, 郑国爽, 赵德伟. 基于网络药理学探讨银杏叶干预激素性股骨头坏死的作用机制[J]. 中国临床药理学与治疗学, 2023, 28(3): 266-275. |
| [14] | 李晨豪, 喻喜华, 闫文浩, 柴宇霞, 李燕燕, 李 锟, 李泽运. 儿童癫痫与维生素D相关性研究进展[J]. 中国临床药理学与治疗学, 2023, 28(11): 1299-1306. |
| [15] | 党洋斌, 梁宇欣, 王天成. 进行性肌阵挛癫痫相关治疗的研究进展[J]. 中国临床药理学与治疗学, 2023, 28(10): 1184-1194. |
| 阅读次数 | ||||||
|
全文 |
|
|||||
|
摘要 |
|
|||||