{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T03:42:12Z","timestamp":1771558932006,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>In Rwanda, epilepsy prevalence ranges between 29\u2030 and 49\u2030. Many women living with epilepsy (WwE) are of childbearing age. Epilepsy characteristics and management, contraception, pregnancy, puerperium and stigma in WwE presenting at the neurology clinic of Ndera, Rwanda, were investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective cross\u2010sectional study investigated demographics, epilepsy characteristics, treatment, contraception, folic acid use, pregnancy, puerperium and stigma in WwE aged \u226518\u2009years. Subgroups were analysed by status of any pregnancy and time of epilepsy diagnosis relative to pregnancy, with significant differences expected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During December 2020 and January 2021, a hundred WwE were enrolled (range 18\u201367\u2009years). Fifty\u2010two women had never been pregnant, 39 women had epilepsy onset before pregnancy and nine were diagnosed after pregnancy. No significant differences in age, marital status or occupation were observed. Contraception was used by 27%, of whom 50% were taking enzyme\u2010inducing anti\u2010epileptic medication. Valproate was used by 46% of WwE of reproductive age. Thirty\u2010nine women with epilepsy onset before pregnancy reported 91 pregnancies, with 14% spontaneous abortions. None used folic acid before conception, and 59% only during pregnancy. Five of 78 newborns were preterm. No offspring had major congenital malformations. Nearly 25% of WwE were not compliant with their anti\u2010epileptic medication schedule during pregnancy or breastfeeding. Internalized stigma was observed in more than 60%. Up to 25% had been discriminated against at school or work.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A comprehensive strategy considering the reproductive health and societal challenges of WwE is needed to drive optimal epilepsy management, reproductive health outcomes and societal inclusion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16254","type":"journal-article","created":{"date-parts":[[2024,3,2]],"date-time":"2024-03-02T05:39:57Z","timestamp":1709357997000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Challenges to epilepsy management in Rwandan women living with epilepsy"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0668-600X","authenticated-orcid":false,"given":"Dirk E.","family":"Teuwen","sequence":"first","affiliation":[{"name":"Department of Neurology University Hospital  Ghent Belgium"},{"name":"4Brain, Department of Neurology, Institute of Neuroscience Ghent University  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arl\u00e8ne","family":"Ndayisenga","sequence":"additional","affiliation":[{"name":"Department of Neurology King Faisal Hospital Rwanda  Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2190-0799","authenticated-orcid":false,"given":"Ieme","family":"Garrez","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital  Ghent Belgium"},{"name":"4Brain, Department of Neurology, Institute of Neuroscience Ghent University  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0742-5661","authenticated-orcid":false,"given":"Fid\u00e8le","family":"Sebera","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital  Ghent Belgium"},{"name":"Department of Neurology Ndera Neuropsychiatric Teaching Hospital  Kigali Rwanda"},{"name":"Department of Internal Medicine Centre Hospitalier Universitaire de Kigali  Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvestre","family":"Mutungirehe","sequence":"additional","affiliation":[{"name":"Department of Neurology Ndera Neuropsychiatric Teaching Hospital  Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josiane","family":"Umwiringirwa","sequence":"additional","affiliation":[{"name":"Department of Neurology King Faisal Hospital Rwanda  Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustapha","family":"Ndiaye","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Pharmacy and Odontology Centre Hospitalier Universitaire de FANN, Universit\u00e9 Cheik Anta Diop  Dakar Senegal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgette","family":"Umuhoza","sequence":"additional","affiliation":[{"name":"Department of Neurology King Faisal Hospital Rwanda  Kigali Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4180-8896","authenticated-orcid":false,"given":"Paul A. 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