Epilepsy in Teenagers: A Study of the Combination of Contraception and Anti-Epileptic Drugs in Treatment
—Based on 32 Cases Collected at the Watsa General Reference Hospital, Haut-Uélé, Democratic Republic of the Congo

Introduction: Epilepsy and its treatments require a number of precautions, both in terms of contraception and during pregnancy, due to the teratogenicity associated with common anti-epileptic drugs. To prevent these risks, we decided to conduct a study of our adolescent patients taking antiepileptic drugs in combination with SAYANA PRESS？ PRESS (A long-acting and reversible contraceptive injection that women can administer themselves every 3 months), in whom we observed a complete cessation of seizures after two years of treatment. This allowed us to study the beneficial effects of combining SAYANA PRESS？, as a contraceptive with either carbamazepine or phenobarbital in adolescents aged 15 to 20 in the province of Haut-Uélé. Materials and Methods: This study employed both retrospective and prospective approaches, with a descriptive and analytical design. It targeted patients diagnosed with epilepsy based on clinical criteria (recurrent epileptic seizures) and paraclinical confirmation through electroencephalography (EEG). The study period extended from January 1, 2014, to December 31, 2023, covering a total duration of ten years. The study population consisted of adolescents aged 15 to 20 years who were followed at the pediatric outpatient clinic of the Watsa General Reference Hospital, located in Haut-Uélé province. All medical records of adolescent patients of childbearing age within this age range, diagnosed with epilepsy and receiving treatment combining Sayana Press？ contraception with an antiepileptic drug, were included. Data collection focused on epidemiological, sociodemographic, and electroclinical variables, using a standardized survey form. Statistical analyses were conducted with SPSS (Statistical Package for the Social Sciences), version 18. Results: From January 1, 2014, to December 31, 2023, we registered 305 pediatric neurology patients, including 158 cases of epilepsy (51.8%) and 32 cases of patients of childbearing age (15 to 20 years old), representing 20% of the total. The average age was 16 years. The patients were from rural areas (84%, 27 cases) and disadvantaged families (78%, 25 cases). Epileptic seizures were generalized in 68.7% (20 cases) and focal in 32.3% (12 cases). The majority of our patients had idiopathic epilepsy (90.6%, 29 cases). All were treated with a combination of antiepileptic drugs and Sayana Press？, contraceptive. Seizures had ceased definitively for 5 years in 81.25% (26 cases), for 2 years in 15.62% (5 cases), and 3.12% (1 case)