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| Vol. 21, No. 1 |
| January 15, 1999 |
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Women with Epilepsy Face Distinct Challenges About half the estimated 200,000 people in Texas diagnosed with epilepsy are women. And as with many other chronic health problems, women and men face different challenges in dealing with the disorder characterized by any of several types of seizures. Often, women with epilepsy notice a relationship between their hormonal cycles and seizures. Deana Loe of Austin certainly did when she first experienced problems as a 17-year-old high school senior. "I seemed to have problems around my cycle," she says. "My parents didn't really know what was wrong until one day I had a seizure in front of my Dad." Even after visiting doctors, Loe says she didn't get a lot of answers. Betty Flores, director of the epilepsy program at Texas Department of Health (TDH), says that greater awareness and education of the public and of health care providers are as essential to the treatment of the disorder as is medication, especially for women. Among the concerns for women with epilepsy are that seizures, and the medications that control them, present several risks for those who are pregnant and their babies. In addition, women taking anti-seizure medication may have lower fertility rates and sexual dysfunction. Seizures often begin at puberty for women, adding to an already stressful time. And because of their longer life expectancy, women are more likely to develop epilepsy later in life than are men. Epilepsy is a general term for a variety of seizure disorders - disturbances in the electrical activity of the brain. About one person in 10 will have some type of seizure at some point in life, and one person in about 100 has some form of epilepsy. In many cases of epilepsy, no cause can be found. For others, the disorder can be linked with strokes, head or birth injuries, brain tumors, poisoning such as lead poisoning, infections and heredity. About 85 percent of those with epilepsy can achieve full or partial control of their seizures. Flores emphasizes that epilepsy is a chronic problem that for many people can be successfully treated. Usually one or a combination of any of 20 anticonvulsant drugs can control seizures, but in some cases treatment includes brain surgery, electronic stimulation of the brain, or a specialized high-fat, low-carbohydrate diet. The disorder is still serious and people can die, especially from prolonged seizures. Of particular concern to many women is pregnancy and birth. "Women with epilepsy need to consult with an obstetrician or gynecologist and a neurologist before planning a family," says Flores. "Oral contraceptives have a higher failure rate in women who take anti-epileptic drugs. And pregnancy may necessitate a change in dosage and/or the type of medication. "But more than 90 percent of women with epilepsy have a normal, healthy child," Flores says. For Loe, getting answers to her questions and being able to learn from others has helped. She has been part of an epilepsy support group for about a year. "I would tell others now that it is good to get a second opinion and that they need to be sure that they get all their questions answered," she says. "That's where a support group is so good." Loe says that despite the problems, she is lucky that she can drive and enjoy a good work atmosphere with the full support of her family. TDH's epilepsy program offers services to people with epilepsy who are not eligible under Medicaid or Medicare or who are uninsured or underinsured. These services, used by about 6,000 Texans in 160 counties, include diagnosis and treatment, a case management system, personal and vocational support services plus public awareness and education. Some of the warning signs associated with epilepsy include:
- Texas Department of Health
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