Women with Epilepsy: May Not Be Getting Adequate Health Care. (Medicine & Health)

Article excerpt

EPILEPSY affects 2,300,000 Americans and 50,000,000 people worldwide. One of the most-common chronic neurological disorders, it begins most frequently in children and older adults. In fact, one has a 10% chance of having a seizure by the age of 75. Epilepsy occurs in both males and females, but affects a woman's health in unique ways, and the treatment of seizures needs to consider the hormonal state of a woman.

I should know, since I have lived with epilepsy for most of my life. No one told me how epilepsy would affect my body or how my hormones would affect my condition because they didn't know at that time. They weren't aware that I might have trouble getting pregnant or that my epilepsy might be related to reproductive problems such as ovarian cysts. They didn't understand that the medication I take places me at greater risk of developing osteoporosis, either.

Today, however, we have enough data about hormones and epilepsy to recognize that you can't treat seizures without understanding the hormonal interactions. Nevertheless, the Epilepsy Foundation hears from women all the time, saying that they weren't getting the information and care they required from their doctors, nurses, and other health care providers, or that they didn't know where to go to get the necessary help.

Epilepsy is a neurological condition characterized by periodic seizures that arise from a disturbance in the normal electrical function of the brain and can last seconds to minutes. What happens during a seizure depends on the type and where it starts in the brain. Some may look like brief staring episodes. Others may make a person confused or affect his or her sensation or movement. Still others, such as a generalized seizure, may result in a loss of consciousness, falling, stiffening of the body, or jerking movements.

Anyone can have a seizure. Sometimes it is known what causes them, but many times it isn't. Certain conditions in the brain that produce seizures may have been present since birth, or they may develop later in life due to injury, infections, structural abnormalities in the brain, exposure to toxic agents, or for reasons that are still not well-understood. People may just have one seizure, triggered by an illness, fever, or severe injury. When seizures continue despite treatment, the cause most likely is epilepsy. The term doesn't mean anything more--just a tendency to have seizures.

About 60% of those who develop seizures will have them go away or be easily treated with medications. At least 1,000,000 Americans each year, though, do not get good control of seizures with medication. When medicines don't work, other treatments may help, such as a special diet (called the ketogenic diet), surgery to remove the area where the seizures begin, or a vagal nerve stimulator, a device that interrupts the signals in the brain that cause them.

About 1,000,000 females in the U.S. have epilepsy. Until recently, it was widely assumed that men and women experience the disorder in essentially the same way. However, this is wrong. Epilepsy is different in women. Seizures may be more or less likely to occur, depending on the actions of the female sex hormones. These vary over a lifetime and over the course of the menstrual cycle, leading to changes in seizure patterns in some susceptible women. In fact, a significant number report that their seizures change or occur more frequently when they go through puberty, at certain times of the month, when they are pregnant, or during the perimenopausal years.

Epilepsy affects women's reproductive health and raises the risk of disorders such as polycystic ovarian syndrome. Chances of becoming pregnant are lower, yet women with epilepsy who become pregnant have around a 90% chance of having a healthy child. For those who aren't trying to have children, their choices for contraception might be limited, since hormonal forms such as the birth control pill have a higher rate of failing in women who also are taking certain medications for seizures. …