November is Nationwide Epilepsy Consciousness Month.
Daybreak Gosselin was 16 years previous when she had her first seizure. “I used to be at a relaxation space in New Jersey, heading dwelling from Washington, D.C., with my highschool band,” she stated. On the time, she chalked it as much as a mixture of being up late together with her associates and being busy, but it surely was extra severe than that. She had epilepsy. Nobody in Gosselin’s household had epilepsy, so far as she knew, so she had no expertise with the situation.
Epilepsy is a mind dysfunction that causes seizures. It impacts greater than 3 million folks in america. Seizures can have an effect on the entire physique or simply part of it, they usually can final just some seconds to some minutes.
Diagnosing epilepsy
There may be many causes of seizures. They are often triggered by alcohol withdrawal, excessive fevers and head accidents, to call just a few. However epilepsy seizures don’t have any identified trigger. In response to Alison M. Pack, M.D., a professor of neurology at Columbia College Irving Medical Middle, an epilepsy prognosis may be made after somebody has two unprovoked seizures. Or, if after one seizure, mind magnetic resonance imaging (MRI) or electroencephalogram (EEG) testing reveals there’s a six in 10 or increased probability that you’ll have one other seizure.
Girls and epilepsy
Epilepsy, as a complete, impacts men and women equally, however there are some particular epilepsy syndromes that extra generally happen in females. One, absence seizures, trigger transient losses of consciousness that appear to be vacant stares. One other is photosensitive epilepsy, the place seizures are triggered by flashing or flickering lights. Gosselin has each. The opposite, extra frequent, one is expounded to the feminine hormones that rise and fall all through the month, estrogen and progesterone. Estrogen may cause seizures, and progesterone can work towards them. When the seizures are associated to menstruation, that is referred to as catamenial epilepsy.
It’s commonplace for teen ladies to begin having epilepsy seizures across the time they begin menstruating, she added. Gosselin’s daughter, who additionally has epilepsy, falls into this class. “She was 12 when she had her first seizure, 5 months earlier than her first interval,” Gosselin stated.
Selecting secure and efficient contraception
Fertile ladies with epilepsy ought to use an efficient type of contraception. “That was one of many primary guidelines I grew up with,” stated Gosselin. “You may’t have any unplanned pregnancies.” Being pregnant isn’t dominated out however ought to be deliberate so mothers-to-be can take medicines that management their seizures however are nonetheless secure for the infant.
Oral contraceptive tablets are some of the standard types of contraception in america. However, they don’t seem to be normally a great possibility for ladies with epilepsy. These tablets include estrogen and progestin (a human-made type of progesterone), or progestin alone. And, based on Pack, many epilepsy medicines produce a liver enzyme that may decrease the effectiveness of oral contraceptives.
Pack believes that the perfect contraceptive for ladies with epilepsy is the IUD, an intrauterine machine. “That is one thing that is generally utilized in the remainder of the world and is gaining traction or acceptability in america,” Pack stated. “IUDs are an excellent type of contraception. You are still ovulating, and if it will get eliminated, you may get pregnant. You do not have a few of the points [related to stopping the pill].”
There are two kinds of IUDs — with and with out hormones. The hormonal IUD releases progestin, however Pack and a colleague ran a examine that checked out how the hormonal IUDs labored together with her sufferers. “We did not see that there was any impact on seizures or on drug ranges in that examine,” she stated.
Being pregnant and epilepsy
Most girls with epilepsy haveprofitable pregnancies, significantly if they’re deliberate. As much as three in 10 are at increased danger for extra seizures, particularly within the first and final trimesters. However most girls who’re seizure-free for 9 months earlier than their being pregnant usually keep seizure-free whereas pregnant.
That being stated, pregnant ladies with epilepsy nonetheless have to be watched carefully by their neurologists. “After I see a person who’s planning a being pregnant or is pregnant, we discuss numerous elements or elements of medicines,” Pack stated. “One is, are your seizures going to be managed? And the second is, what’s the influence on the growing fetus?”
Having a grand mal seizure whereas pregnant may be dangerous to each mom and child, however the medicines to forestall the seizures, total, are pretty secure. Blood ranges that monitor how a lot treatment is current within the blood have to be checked recurrently, so treatment doses can then be adjusted as wanted.
“My seizures have been fairly well-controlled throughout my two pregnancies. I’ve a son, who’s 20 and a daughter, 16,” Gosselin stated. “However, full disclosure, the treatment that I used to be on after I was pregnant, they don’t advocate in the present day [during pregnancy].”
Menopause and epilepsy
Many, however not all, ladies with epilepsy expertise modifications of their seizures after they enter menopause. Some ladies whose seizure patterns change throughout menopause have worse or extra frequent seizures, however others have fewer. Girls who’ve catamenial epilepsy typically have extra seizures whereas in perimenopause however then fewer as soon as in menopause.
One other problem for ladies with epilepsy is that they’ve an elevated danger for osteoporosis (weakening of the bones) for 2 causes. One is that epilepsy medicines can have an effect on their bone density. The opposite is that hormone remedy with estrogen, which can assist hold bones robust, is just not an possibility for ladies with epilepsy as a result of it might probably improve their danger of seizures.
Epilepsy and reproductive problems
Girls with epilepsy have the next price of some reproductive problems, similar to:
The precise cause is just not but identified, however it’s possible associated to the truth that epilepsy and anti-seizure medicines can have an effect on intercourse hormones in addition to fertility. They will additionally improve the danger of growing PCO and PCOS, particularly if the medicines embrace an ingredient referred to as sodium valproate.
Studying to reside with epilepsy
Residing with epilepsy has its challenges, however a technique to enhance your expertise is to remain knowledgeable. It’s vital for ladies with epilepsy to ask questions on their well being and proceed to ask questions as they become old.
“You’re your individual advocate. Don’t be afraid to teach your self and others,” Gosselin stated. “It may not simply provide help to however will assist the following one that wants it.”
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