November is National Epilepsy Awareness 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 mates and being busy, however it was extra critical 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 people in america. Seizures can have an effect on the entire physique or simply part of it, they usually can final only a few seconds to a couple minutes.
Diagnosing epilepsy
There could be many causes of seizures. They are often triggered by alcohol withdrawal, excessive fevers and head accidents, to call a number of. However epilepsy seizures don’t have any recognized trigger. In keeping with Alison M. Pack, M.D., a professor of neurology at Columbia College Irving Medical Heart, an epilepsy prognosis could be made after somebody has two unprovoked seizures. Or, if after one seizure, mind magnetic resonance imaging (MRI) or electroencephalogram (EEG) testing exhibits there’s a six in 10 or increased probability that you should have one other seizure.
Girls and epilepsy
Epilepsy, as a complete, impacts women and men equally, however there are some particular epilepsy syndromes that extra generally happen in females. One, absence seizures, trigger temporary losses of consciousness that appear like vacant stares. One other is photosensitive epilepsy, the place seizures are triggered by flashing or flickering lights. Gosselin has each. The opposite, extra widespread, 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 common for teen women to start out 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 protected and efficient contraception
Fertile girls with epilepsy ought to use an efficient type of birth control. “That was one of many most important guidelines I grew up with,” stated Gosselin. “You possibly can’t have any unplanned pregnancies.” Being pregnant isn’t dominated out however needs to be deliberate so mothers-to-be can take drugs that management their seizures however are nonetheless protected for the child.
Oral contraceptive tablets are one of the vital widespread types of contraception in america. However, they aren’t normally an excellent possibility for women with epilepsy. These pills contain estrogen and progestin (a human-made type of progesterone), or progestin alone. And, in accordance with Pack, many epilepsy drugs produce a liver enzyme that may decrease the effectiveness of oral contraceptives.
Pack believes that the most effective contraceptive for ladies with epilepsy is the IUD, an intrauterine device. “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 will 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 study 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 research,” she stated.
Being pregnant and epilepsy
Most girls with epilepsy havesuccessful pregnancies, particularly if they are planned. Up to three in 10 are at higher risk for more seizures, particularly within the first and final trimesters. However most girls who’re seizure-free for 9 months earlier than their being pregnant typically keep seizure-free whereas pregnant.
That being stated, pregnant girls with epilepsy nonetheless must be watched intently by their neurologists. “After I see a person who’s planning a being pregnant or is pregnant, we speak about numerous components or parts of medicines,” Pack stated. “One is, are your seizures going to be managed? And the second is, what’s the impression on the growing fetus?”
Having a grand mal seizure whereas pregnant could be dangerous to each mom and child, however the drugs to forestall the seizures, total, are pretty protected. Blood ranges that monitor how a lot medicine is current within the blood must be checked often, so medicine doses can then be adjusted as wanted.
“My seizures had 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 medicine that I used to be on after I was pregnant, they don’t suggest at the moment [during pregnancy].”
Menopause and epilepsy
Many, however not all, girls with epilepsy expertise modifications of their seizures once they enter menopause. Some girls whose seizure patterns change during 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 drugs can have an effect on their bone density. The opposite is that hormone remedy with estrogen, which may help maintain bones robust, isn’t an possibility for ladies with epilepsy as a result of it may improve their danger of seizures.
Epilepsy and reproductive issues
Girls with epilepsy have the next charge of some reproductive issues, akin to:
The precise motive isn’t but recognized, however it’s possible associated to the truth that epilepsy and anti-seizure medications can have an effect on intercourse hormones in addition to fertility. They’ll additionally improve the chance of developing PCO and PCOS, particularly if the drugs embrace an ingredient referred to as sodium valproate.
Studying to dwell with epilepsy
Dwelling with epilepsy has its challenges, however a method 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 personal advocate. Don’t be afraid to coach your self and others,” Gosselin stated. “It won’t simply assist you to however will assist the following one who wants it.”
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