Neurology and Psychiatry of Women: A Guide to Gender-based Issues in Evaluation, Diagnosis, and Treatment [1st ed.] 978-3-030-04244-8, 978-3-030-04245-5

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Neurology and Psychiatry of Women: A Guide to Gender-based Issues in Evaluation, Diagnosis, and Treatment [1st ed.]
 978-3-030-04244-8, 978-3-030-04245-5

Table of contents :
Front Matter ....Pages i-xi
Front Matter ....Pages 1-1
Women and Migraine (Regina Krel, Paul G. Mathew)....Pages 3-5
Connective Tissue Disorders in Women (Sophia L. Ryan, Shamik Bhattacharyya, Mary Angela O’Neal)....Pages 7-13
Functional Neurological Disorder and Dissociative Disorders in Women (Geoffrey Raynor, Gaston Baslet)....Pages 15-26
Contraception in Neurologic and Psychiatric Disorders (Caryn Dutton, Andrea Hsu Roe, Deborah Bartz)....Pages 27-36
Neuroendocrine Disorders in Women (Alexandra J. Lovett, Whitney W. Woodmansee)....Pages 37-45
Somatoform Disorders (Timothy M. Scarella)....Pages 47-67
Anxiety Disorders (Madeleine A. Becker, Nazanin E. Silver, Ann Chandy, Subani Maheshwari)....Pages 69-76
Neuro-inflammatory Disorders in Women (Ivana Vodopivec)....Pages 77-83
Catamenial Epilepsy (P. Emanuela Voinescu)....Pages 85-94
Neuro-oncological Disorders in Women (Na Tosha N. Gatson, Erika N. Leese)....Pages 95-101
Substance Use Disorders in Women (Whitney Peters, Connie Guille, Leena Mittal)....Pages 103-113
Front Matter ....Pages 115-115
Neurologic Imaging in Pregnancy (Jesse M. Thon, Robert Regenhardt, Joshua P. Klein)....Pages 117-120
The Normal Physiology of Pregnancy: Neurological Implications (Cesar R. Padilla, Nicole A. Smith)....Pages 121-123
Epilepsy and Pregnancy (Mariel Velez, Kimford J. Meador)....Pages 125-129
Headaches in Pregnancy and Postpartum (Mary Angela O’Neal)....Pages 131-138
Stroke in Pregnancy (Steven K. Feske)....Pages 139-143
Demyelinating Disease and Pregnancy (Tamara B. Kaplan, Riley Bove)....Pages 145-156
Mood Disorders in Pregnancy (Kara Brown, Dylan Kathol)....Pages 157-172
Postpartum Neuropathy (Janet F. R. Waters)....Pages 173-176
Myasthenia Gravis and Pregnancy (Christyn Edmundson, Mohammad Kian Salajegheh)....Pages 177-182
Ethical Decisions in Pregnancy (Thomas I. Cochrane)....Pages 183-187
Front Matter ....Pages 189-189
Menopausal Hot Flashes, Sleep and Mood Disturbances (Geena Athappilly, Margo Nathan)....Pages 191-203
Stroke Risk Factors in Women (Emer R. McGrath, Kathryn M. Rexrode)....Pages 205-211
Gender Differences in Parkinson’s Disease (Michael T. Hayes)....Pages 213-217
Sex-Related Differences in Alzheimer’s Disease (Diler Acar, Carolyn Jane King)....Pages 219-225
Successful Aging (Marie Pasinski)....Pages 227-231
Back Matter ....Pages 233-243

Citation preview

Mary Angela O’Neal  Editor

Neurology and Psychiatry of Women A Guide to Gender-based Issues in Evaluation, Diagnosis, and Treatment

123

Neurology and Psychiatry of Women

Mary Angela O’Neal Editor

Leena Mittal Guest Editor

Neurology and Psychiatry of Women A Guide to Gender-based Issues in Evaluation, Diagnosis, and Treatment

Editor Mary Angela O’Neal Department of Neurology Brigham and Women’s Hospital Boston, MA USA Guest Editor Leena Mittal Department of Psychiatry Brigham and Women’s Hospital Boston, MA USA

ISBN 978-3-030-04244-8    ISBN 978-3-030-04245-5 (eBook) https://doi.org/10.1007/978-3-030-04245-5 Library of Congress Control Number: 2019930963 © Springer Nature Switzerland AG 2019 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

Preface

The need to understand how neurologic and psychiatric disorders are different in women is important to appropriately care for female patients. There is a vast amount of knowledge about how sex affects disease incidence, course, and treatment, as well as how drugs and disease interact with reproductive health, pregnancy, and menopause. Yet many practitioners only have a limited understanding of these important concerns. Further, there is no single text which provides this critical information. This book was written for all providers who take care of women with these conditions to provide sex-appropriate care guidelines. Many providers think that women’s issues in medicine only relate to pregnancy. In fact, gender concerns are important throughout a woman’s life. Of course, the factors important to consider vary as to where patients are in their life cycle. For example, to understand stroke risk in women, a history regarding pregnancy-related disorders such as preeclampsia/eclampsia and gestational diabetes is essential. I wanted to assemble a comprehensive textbook that reflects the significant issues as regards both neurologic and psychiatric disorders spanning a woman’s life including reproductive health, pregnancy, and healthy aging. Each chapter is written by experts in their field to give practical up-to-date advice about some of the considerations to best address our female patients’ health. I hope you enjoy reading the book. Boston, MA, USA

Mary Angela O’Neal, MD

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Contents

Part I Issues in Women During Their Reproductive Years Women and Migraine���������������������������������������������������������������������������������������������������������   3 Regina Krel and Paul G. Mathew Connective Tissue Disorders in Women���������������������������������������������������������������������������   7 Sophia L. Ryan, Shamik Bhattacharyya, and Mary Angela O’Neal Functional Neurological Disorder and Dissociative Disorders in Women���������������������  15 Geoffrey Raynor and Gaston Baslet Contraception in Neurologic and Psychiatric Disorders�������������������������������������������������  27 Caryn Dutton, Andrea Hsu Roe, and Deborah Bartz Neuroendocrine Disorders in Women�������������������������������������������������������������������������������  37 Alexandra J. Lovett and Whitney W. Woodmansee Somatoform Disorders�������������������������������������������������������������������������������������������������������  47 Timothy M. Scarella Anxiety Disorders���������������������������������������������������������������������������������������������������������������  69 Madeleine A. Becker, Nazanin E. Silver, Ann Chandy, and Subani Maheshwari Neuro-inflammatory Disorders in Women�����������������������������������������������������������������������  77 Ivana Vodopivec Catamenial Epilepsy�����������������������������������������������������������������������������������������������������������  85 P. Emanuela Voinescu Neuro-oncological Disorders in Women���������������������������������������������������������������������������  95 Na Tosha N. Gatson and Erika N. Leese Substance Use Disorders in Women ��������������������������������������������������������������������������������� 103 Whitney Peters, Connie Guille, and Leena Mittal Part II Pregnancy Neurologic Imaging in Pregnancy������������������������������������������������������������������������������������� 117 Jesse M. Thon, Robert Regenhardt, and Joshua P. Klein The Normal Physiology of Pregnancy: Neurological Implications�������������������������������� 121 Cesar R. Padilla and Nicole A. Smith Epilepsy and Pregnancy����������������������������������������������������������������������������������������������������� 125 Mariel Velez and Kimford J. Meador Headaches in Pregnancy and Postpartum ����������������������������������������������������������������������� 131 Mary Angela O’Neal

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Stroke in Pregnancy����������������������������������������������������������������������������������������������������������� 139 Steven K. Feske Demyelinating Disease and Pregnancy����������������������������������������������������������������������������� 145 Tamara B. Kaplan and Riley Bove Mood Disorders in Pregnancy������������������������������������������������������������������������������������������� 157 Kara Brown and Dylan Kathol Postpartum Neuropathy����������������������������������������������������������������������������������������������������� 173 Janet F. R. Waters Myasthenia Gravis and Pregnancy����������������������������������������������������������������������������������� 177 Christyn Edmundson and Mohammad Kian Salajegheh Ethical Decisions in Pregnancy����������������������������������������������������������������������������������������� 183 Thomas I. Cochrane Part III Women’s Health and Aging Menopausal Hot Flashes, Sleep and Mood Disturbances����������������������������������������������� 191 Geena Athappilly and Margo Nathan Stroke Risk Factors in Women������������������������������������������������������������������������������������������ 205 Emer R. McGrath and Kathryn M. Rexrode Gender Differences in Parkinson’s Disease ��������������������������������������������������������������������� 213 Michael T. Hayes Sex-Related Differences in Alzheimer’s Disease��������������������������������������������������������������� 219 Diler Acar and Carolyn Jane King Successful Aging ����������������������������������������������������������������������������������������������������������������� 227 Marie Pasinski Index������������������������������������������������������������������������������������������������������������������������������������� 233

Contents

Contributors

Diler Acar, MD  Brigham and Women’s Hospital, Boston, MA, USA Geena Athappilly, MD  Harvard Medical School, Boston, MA, USA Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA Site Director for Boston University Family Medicine Residency at Edith Nourse Rogers Memorial Veteran Affairs Hospital, Boston, MA, USA Deborah  Bartz, MD, MPH Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA Gaston Baslet, MD  Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA Madeleine A. Becker, MD, FACLP  Department of Psychiatry and Human Behavior, Thomas Jefferson University Hospital, Philadelphia, PA, USA Shamik  Bhattacharyya, MD, MS Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA Riley  Bove, MD, MMSc  Department of Neurology, Weill Institute for the Neurosciences, University of California, San Francisco, CA, USA Kara  Brown, MD  Southeast Louisiana Verterans Health Care System, New Orleans, LA, USA Ann  Chandy, MD Department of Psychiatry and Human Behavior, Thomas Jefferson University Hospital, Philadelphia, PA, USA Thomas  I.  Cochrane, MD, MBA Brigham and Women’s Hospital, Center for Bioethics, Harvard Medical School, Boston, MA, USA Caryn Dutton, MD, MS  Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA Christyn Edmundson, MD  Division of Neuromuscular Medicine, Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA Steven  K.  Feske, MD Harvard Medical School, Division of Stroke and Cerebrovascular Disease, Neurology Department, Brigham and Women’s Hospital, Boston, MA, USA Na Tosha N. Gatson, MD, PhD  Geisinger Neuroscience Institute, Danville, PA, USA Geisinger Cancer Institute, Danville, PA, USA

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Connie Guille, MD  Medical University of South Carolina, Institute of Psychiatry, Charleston, SC, USA Michael T. Hayes, MD  Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA South Shore Hospital, Weymouth, MA, USA Harvard Medical School, Boston, MA, USA Tamara B. Kaplan, MD  Department of Neurology, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA Dylan  Kathol, MD Department of Psychiatry, NorthShore University Health System, Evanston, IL, USA Carolyn Jane King, BA  Brigham and Women’s Hospital, Boston, MA, USA Joshua  P.  Klein, MD, PhD Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA Regina Krel, MD  Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, USA Neuroscience Institute, Hackensack University Medical Center, Hackensack, NJ, USA Brigham & Women’s Hospital, Department of Neurology, John R. Graham Headache Center, Boston, MA, USA Harvard Vanguard Medical Associates, Department of Neurology, Braintree, MA, USA Cambridge Health Alliance, Division of Neurology, Cambridge, MA, USA Harvard Medical School, Boston, MA, USA Erika N. Leese, PA-C  Geisinger Neuroscience Institute, Danville, PA, USA Alexandra J. Lovett, MD  Massachusetts General Hospital, Boston, MA, USA Subani Maheshwari, MD  Department of Psychiatry, Wilmington Hospital, Christiana Care Health System, Wilmington, DE, USA Paul  G.  Mathew, MD, DNBPAS, FAAN, FAHS  Hackensack University Medical Center, Hackensack, NJ, USA Seton Hall University, Nutley, NJ, USA Brigham & Women’s Hospital, Department of Neurology, John R. Graham Headache Center, Boston, MA, USA Harvard Vanguard Medical Associates, Department of Neurology, Braintree, MA, USA Emer R. McGrath, MB, PhD  Department of Neurology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA Kimford  J.  Meador, MD  Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, USA Leena Mittal, MD  Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA Margo  Nathan, MD Division of Women’s Mental Health and Department of Psychiatry, Harvard Medical School, Brigham and Women’s Hospital, Boston, MA, USA Mary  Angela  O’Neal, MD Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA Cesar R. Padilla, MD  Brigham and Women’s Hospital, Boston, MA, USA

Contributors

Contributors

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Marie Pasinski, MD  Harvard Medical School, Nahant, MA, USA Whitney  Peters, MD Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA Geoffrey Raynor, MD  Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, USA Robert  Regenhardt, MD, PhD Partners Neurology Residency Program, Brigham and Women’s Hospital, Massachusetts General Hospital, Boston, MA, USA Kathryn M. Rexrode, MD, MPH  Division of Women’s Health, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA Andrea  Hsu  Roe, MD, MPH  Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Sophia L. Ryan, MD  Department of Neurology, Brigham and Women’s Hospital, Boston, MA, USA Department of Neurology, Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Boston, MA, USA Mohammad Kian Salajegheh, MD  Neuromuscular Center & EMG Laboratory, Department of Neurology, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA Timothy M. Scarella, MD  Department of Psychiatry, Beth Israel Deaconess Medical Center/ Harvard Medical School, Boston, MA, USA Nazanin E. Silver, MD, MPH, FACOG  Division of Women’s Behavioral Health, Department of Obstetrics and Gynecology, University of Pittsburg Medical Center Pinnacle, Camp Hill, PA, USA Nicole  A.  Smith, MD, MPH Maternal Fetal Medicine, Brigham and Women’s Hospital, Boston, MA, USA Department of ob/gyn, Brigham and Women’s Hospital, Boston, MA, USA Jesse  M.  Thon, MD Department of Neurology, Massachusetts General Hospital, Boston, MA, USA Mariel Velez, MD, PhD  California Pacific Medical Center, California Pacific Neurosciences Institute, San Francisco, CA, USA Ivana  Vodopivec, MD, PhD Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA P. Emanuela Voinescu, MD, PhD  Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA Janet F.R. Waters, MD, MBA  University of Pittsburgh Medical Center, Pittsburgh, PA, USA Whitney  W.  Woodmansee, MD Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA

Part I Issues in Women During Their Reproductive Years

Women and Migraine Regina Krel and Paul G. Mathew

Women and Migraine Migraine is a condition which affects over 36 million people in the United States alone [1]. These vast numbers make migraine the third most common condition and sixth most disabling condition worldwide [2]. Up until puberty, the ratio of female-to-male sufferers is approximately equal, however this ratio significantly shifts at the onset of menarche, at which time the ratio increases to a nearly 3:1 female-to-male ratio. A diagnosis of migraine is established through taking a thorough history, performing a physical examination, and by ruling out secondary causes of headache with additional testing based on clinical suspicion, such as neuroimaging. The diagnostic criteria for migraine is established in the The International Classification of Headache Disorders Third Edition (ICHD) (Table 1) [3]. An estimated 11% of women who suffer from migraines have headache onset at the time of menarche. This population R. Krel Hackensack Meridian School of Medicine at Seton Hall University, Nutley, NJ, USA Neuroscience Institute, Hackensack University Medical Center, Hackensack, NJ, USA Brigham & Women’s Hospital, Department of Neurology, John R. Graham Headache Center, Boston, MA, USA Harvard Vanguard Medical Associates, Department of Neurology, Braintree, MA, USA Cambridge Health Alliance, Division of Neurology, Cambridge, MA, USA Harvard Medical School, Boston, MA, USA P. G. Mathew (*) Hackensack University Medical Center, Hackensack, NJ, USA Seton Hall University, Nutley, NJ, USA Brigham & Women’s Hospital, Department of Neurology, John R. Graham Headache Center, Boston, MA, USA Harvard Vanguard Medical Associates, Department of Neurology, Braintree, MA, USA e-mail: [email protected]

subset is more likely to develop menstrual migraine [4]. Migraines which have a close menstrual association are further classified by ICHD into pure menstrual migraine without aura or menstrually related migraine without aura (Table  2). Studies demonstrate that menstrually related migraine is far more common than pure menstrual migraine, and can be present in 20–60% of women compared to pure menstrual migraine which occurs in 50% decrease) [11]. Drug levels typically normalize to pre-pregnancy values by 2 weeks post partum [12].

© Springer Nature Switzerland AG 2019 M. A. O’Neal (ed.), Neurology and Psychiatry of Women, https://doi.org/10.1007/978-3-030-04245-5_13

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Hematologic Changes in Pregnancy Normal pregnancy is a prothrombotic state, characterized by increased procoagulant factors II, VII, VIII, X, XII, and XIII, and von Willbrand’s factor, reduced anticoagulant factors including protein S and antithrombin, and reduced fibrinolysis. Coagulation parameters typically normalize by 6–8 weeks postpartum, with earlier resolution of some values. This state of hypercoagulation is somewhat compensated by a state of fibrinolysis, as evidenced by an increase in fibrin degradation products in parturients [4]. Should coagulation testing be indicated, the prothrombin time and activated partial thromboplastin time typically remain normal. D-dimer can be elevated in pregnancy, resulting in low sensitivity and specificity for clot. Negative predictive value is likely unchanged. Evidence of hypercoagulability has been well documented with novel assays, such as thromboelestography, which can give pertinent findings of coagulation activity in the clinical setting [13]. As plasma volume increases, red blood cell mass increases as well, starting in the first trimester. Increase in red blood cell mass will peak at 20–30% in the third trimester, in women taking iron supplementation. Total iron requirements are close to 1000 mg over the entirety of pregnancy. Even in women taking iron supplementation, iron deficiency anemia is relatively common, defined by the Centers for Disease Control and prevention as a hemoglobin value of