Patient Safety Alert: NHS Improvements Resources to support safe use of valproate 4 April 2017
Kim is an award winning registered midwife, nurse and independent nurse prescriber with additional qualifications in epilepsy, complex pregnancies, child protection, pharmacology, research, epidemiology and advanced clinical practice. Kim specialises in antiepileptic drug prescribing management and all aspects of epilepsy. She conducts a unique service alongside her obstetric colleagues, personalising holistic care and treatment support from the preconception years to motherhood.
Kim Morley, Epilepsy Specialist Nurse/Midwife Practitioner, Florence Portal House, Royal Hampshire County Hospital, Romsey Rd, Winchester, SO22 5DG. Email: firstname.lastname@example.org Appointments: 01962 824210 Twitter: @epilepsymidwife
A new peer reviewed maternity epilepsy toolkit designed to improve history taking; reduce risk, increase knowledge and awareness and provide a summary of a woman’s epilepsy management in pregnancy. Documentation should start at the booking appointment and continue throughout pregnancy and the postnatal period. Please use alongside information from the RCOG green top epilepsy in pregnancy guidelines (2016) and this website. Click on the PDF below to download and print the PDF double sided to form a three page booklet. Qualitative research into midwives views of toolkit starting soon.
16/03/17 Epilepsy Specialist Interest Group Bristol Audio presentation, Perinatal women with epilepsy
12/01/17 Education Centre, Queen Alexandra Hospital, 'Epilepsy in Pregnancy'. Obs & Gynae trainees.
11/01/17 LSA Annual Southern Supervisors of Midwives Conference, Reading 'Women with epilepsy'.
29/11/16 Epilepsy Action Professional Workshop, St Peter’s Hospital. 'Epilepsy in pregnancy'
16/11/16 University of Hertfordshire Current Research on epilepsy assessment, treatment and management (genetics) and evidence based practice.
19-20/1016: RCM conference the contribution midwives can make in reducing human factors associated with poor fetal and maternal outcomes in women with epilepsy.
12/10/16 University of Hertfordshire Epilepsy Pharmacology, Emergency management & Toolkit for epilepsy management
5/10/16 ILAE British Chapter Dublin.'Validation of an epilepsy shared-care toolkit designed to reduce disparity in maternity care provision'.
14/09/16 University of Hertfordshire (Oxford Study Centre) Epilepsy Diagnosis and Differential Diagnosis
New evidence in France of harm from epilepsy drug valproate BBC News 20/04/17 Important for women taking valproate to have preconception counselling whilst using effective contraception. Please do not just stop your medication because of the risk from seizures if you are unmedicated. Do consult your doctor promptly for advice and specialist referral.
NHS Improvements Safety Alert resources to support safe use of valproate Click: MHRA Alert 6/4/17
If you are prescribed sodium valproate & a woman of child-bearing potential, please use effective contraception and seek prompt preconception advice to help you with decision making and choice for future child-bearing. If your baby has been exposed to valproate & your are concerned about your child's development, please discuss this with your GP and health visitor
Important information for girls and young women: sodium valproate and pregnancy. Click: Medicines For Children 22/03/17
Two students have invented the MediVest’ for people with epilepsy. The designers claim this device monitors heart rate variability and body temperature to predict a seizure up to eight minutes in advance. Epilepsy vest award. As with any seizure detection device, featuring on this website is not an endorsement of its efficacy. For further information please see: Epilepsy Action Daily Living Aids
ILAE Classification of the Epilepsies (2017): Position paper of the ILAE Commission for Classification and Terminology
European Medicines Agency launches new safety review of prenatal valproate exposure Medscape 10/03/17
CBT nonadherence common in patients with psychogenic seizures Medscape 16/12/16
New ILAE classification of seizures Medscape 12/12/16
France sets up fund for Sanofi epilepsy drug victims Reuters 16/11/16
Women with epilepsy should be better informed about risks associated with sodium valproate in pregnancy Epilepsy Action Survey, published 31 October 2016. If you would like further information, please click on MHRA Toolkit for women taking sodium valproate and arrange to see your GP if you have not had the opportunity of a review of your epilepsy and treatment.
MHRA alert: Retigabine (Trobalt) withdrawal from all markets by June 2017. If you take this antiepileptic drug, please click on the link above and see your prescriber as soon as possible to discuss future treatment management.
Emergency contraception update MHRA: interaction with enzyme inducing drugs September 2016
New RCOG patient information leaflet: Bleeding or pain in early pregnancy published September 2016
According to a new study, pregnant women & new mothers with epilepsy have reduced life satisfaction
Ten thousand pregnant women took epilepsy drug that raises risk of birth defects Daily Telegraph 10 August 2016. To provide accurate individual counselling about the safety of antiepileptic drugs taken during pregnancy, please contact the UK Epilepsy & Pregnancy Register.
SUDEP article epilepsy pregnancy and maternal deaths 20 June 2016. To assess your own risks and take control to reduce these risks, see Pregnancy toolkit and download EpSMon app free of charge.
Speaking up for women with epilepsy Huffington Post article published 19th May 2016
Al Wattar B, Tamilselvan K, Khan R, Kelso A, Sinha A, Pirie A, McCorry D, Khan K and Thangaratinam S (2016) 'Development of a core outcome set for epilepsy in pregnancy (E-CORE): a national multi-stakeholder modified Delphi consensus study', BJOG: An International Journal Of Obstetrics And Gynaecology, MEDLINE, EBSCOhost, viewed 14 December 2016.
Asadi-Pooya AA (2015) Review: High dose folic acid supplementation in women with epilepsy: Are we sure it is safe?. Seizure: European Journal Of Epilepsy 27: 51-53
BNF on line service BNF publications
Bromley R (2016) 'The treatment of epilepsy in pregnancy: The neurodevelopmental risks associated with exposure to antiepileptic drugs. Reproductive Toxicology 64, 44th Annual Conference of the European Teratology Society 203-210
Epilepsy Specialist Nurse Association (ESNA) Contact:ESNA online
Generalised Anxiety Disorder Assessment: GAD-7 Anxiety Test Questionnaire
Herzog A, Mandle H, Cahill K, Fowler K, Hauser W and Davis, A (2016) Contraceptive practices of women with epilepsy: Findings of the epilepsy birth control registry. Epilepsia (Series 4), 57(4): 630-637
NHS Choices: Moodzone: Self help toolkit for Stress, Anxiety & Depression
Patient health questionnaire (PHQ-9) Instrument for measurement of common mental health disorders
Preventing maternal mortality: Its better to ask Royal College of Physicians and Surgeons of Glasgow & Royal College of Obstetricians & Gynaecologists.
Reiter S, Bjørk M, Daltveit A, Veiby G, Kolstad E, Engelsen B and Gilhus N (2016) Life satisfaction in women with epilepsy during and after pregnancy. Epilepsy & Behavior 62: 251-257 http://www.sciencedirect.com/science/article/pii/S1525505016302037
Royal College of General Practitioners Clinical epilepsy resources
Royal College of Obstetricians and Gynaecologists: RCOG information leaflet for women with epilepsy in pregnancy
Royal College of Psychiatry: Mental Health Problems in Pregnancy
Spencer B (2015) 'Medications and Breastfeeding for Mothers With Chronic Illness' JOGNN: Journal Of Obstetric, Gynecologic & Neonatal Nursing 44(4): 543
UK Teratology Information Service UKTIS for information leaflets about topiramate, gabapentin, pregabalin, sodium valproate, carbamazepine and lamotrigine
Weston J, Bromley R, Jackson CF, Adab N, Clayton-Smith J, Greenhalgh J, Hounsome J, McKay AJ, Tudur Smith C and Marson AG (2016) Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child Cohrane Database of Systematic Reviews 11 Available from: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD010224.pub2/epdf
International League Against Epilepsy Guidelines, Reports & Position Papers on Epilepsy
NICE clinical guideline 137 (2012) The epilepsies: the diagnosis and management of the epilepsies in adults and children in primary and secondary care.
Epilepsy Action Research studies
Epilepsy Society Research projects
Epilepsy Research UK Transforming lives through research
Morley K (2016, October) Validation of an epilepsy shared-care toolkit designed to reduce disparity in maternity care provision. Poster presented at the International League Against Epilepsy (ILAE) British Chapter Conference, Dublin, Republic of Ireland.
Morley K (2016) Specialist Midwifery (pt 2) The career journey of an epilepsy specialist midwife practitioner Epilepsy Professional Autumn 2016 Leeds: Epilepsy Action (42): 24-27
Morley K (2016) More than a midwife Epilepsy Today September 2016 Leeds: Epilepsy Action (131): 18-20
Morley K (2016) Looking forward IN: Academy of Royal Colleges (eds) A vision of healthcare 20/20. London: Academy of Royal Colleges 102-103 pdf
Morley K (2016) Specialist Midwifery (pt 1) The career journey of an epilepsy specialist midwife practitioner Epilepsy Professional Summer 2016 Leeds: Epilepsy Action (41): 18-22
Morley K (2016) Antiepileptic drug management during pregnancy: A shared decision approach. British Journal of Midwifery 24(5): 353-361 Available from: http://www.magonlinelibrary.com/doi/10.12968/bjom.2016.24.5.353
Morley K (2016) Optimising midwifery care for women with epilepsy. Nursing in Practice. Available from: http://www.nursinginpractice.com/article/optimising-midwifery-care-women-epilepsy
Morley K (2010) Book review: Effective Migraine Treatment in Pregnant & Lactating Women: A Practical Guide. Authors: DA Marcus and PA Bain (2009) Humana Press The Obstetrician & Gynaecologist 12(1): 6 Link
Morley K (2009) Specialist midwife-epilepsy Disability, Pregnancy & Parenthood International 66.
Morley K (2009) Sudden unexpected disablement Disability, Pregnancy & Parenthood International 66
Morley K (2008) Improving care for women with epilepsy. British Journal of Midwifery 16(10): 649-655 Available from: http://www.magonlinelibrary.com/doi/abs/10.12968/bjom.2008.16.10.31233