FERTILITY IN ADOLESCENTS WITH EPILEPSY

SAŽETAK Napredak u neuropedijatriji, a posebno u epilepsiji, ide velikim koracima naprijed, od razumijevanja patogenetskih mehanizama do novih antiepileptika, neurokirurških i ostalih vrsta liječenja. Budući da većina bolesnika s epilepsijom postaje kronično bolesno već u djetinjstvu, taj napredak je jednako značajan i za pedijatre i za neurologe za odrasle. Čak i zdravi adolescenti imaju specifične probleme s usvajanjem zdravih navika i stila života (debljina, mentalno zdravlje, smrtnost u prometu, samoubojstva, abuzus droga i alkohola koji kasnije rezultiraju asocijalnim ponašanjem, te posebno tinejdžerske trudnoće koje su u porastu, kao i spolno prenosive bolesti). Teret kronične bolesti u adolescenciji povećava se u svim razvijenim zemljama, budući da tada kada kronično bolesna djeca dožive svoje tinejdžersko doba i dvadesete, moraju istovremeno donositi važne odluke (poput izbora zvanja), međuljudski odnosi unutar obitelji i prijatelja postaju zamršeniji, spomenimo i spolnost, kontracepciju i pitanje koje uvijek visi u zraku – prekinuti terapiju ili ne. Tek nedavno se pažnja usmjerila na važnost i neadekvatno zbrinjavanje te dobne skupine. Treba prepoznati specifične potrebe mladih ljudi koji prolaze kroz period koji je sam po sebi turbulentan, a kada je još opterećen epilepsijom, predstavlja veliki izazov, kako za njih, tako i za njihove liječnike.ABSTRACT Progress in neuropediatrics, especially in pediatric epilepsy is advancing on a broad front, from new understandings of pathogenetic mechanisms to novel pharmacologic, surgical and nonsurgical various treatments.Because most epilepsy patients have epilepsy from childhood, these developments are relevant to both pediatric and adult neurologists. Even healthy adolescents have specific problems with adopting helathy life habits and life –styles (obesity, mental health, traffic traumas, suicide attempts, abuse of recreational drugs and alcohol which later result in asocial behaviour, and especially teenager pregnancies which are in constant uprise, together with sexually transmitted diseases. The burden of chronic illness in adolescence is increasing in all developed countries, because all chronically ill patients live through their teens until their twenties. This is the time in their lives when young people at the same time have to make serious decisions- the choice of employment, relationships within the family and friends, issue of sexuality, contaception and the ever present question – whether to discontinue the antiepileptic therapy or not. Recent attention has focused on the importance, but inadequacy, of adolescent medicine and the paucity od medical services for this specific population.Adolescence is in itself, a difficult and traumatic time, when complicated by epilepsy it poses a great challenge not only to the young people themselves, but also to their carers and physicians