Understanding the Female Brain: Epilepsy

Introduction

First diagnosed with epilepsy when she was 17 years old, Ann O'Shea experienced one to two seizures a year before getting her condition under control with a medication called lamotrigine. When she decided to go on birth control at age 22, very little was explained to her about the impact it could have on her epilepsy medication.

Main Item

Epilepsy is a brain disorder in which a person has repeated seizures (convulsions) over time. Seizures are episodes of disturbed brain activity that cause changes in attention or behavior. There are different types of epilepsy and seizures. Epilepsy drugs are prescribed to control seizures, and rarely surgery is necessary if medications are ineffective.

Within two months, O'Shea had three seizures - far more than what she had experienced in the past. Recognizing that there may be a connection, O'Shea turned to the Internet for research and found information about how birth control pills could decrease the efficacy the medication she was taking to control seizures. Concerned that this had not been caught by her doctors, she decided it was time to find a specialist who would not only care for her epilepsy, but could also help her plan for the future. That's how she found the Northwestern Medicine® Women's Neurology Center, a program dedicated to better serving women at all stages of life and to advancing research in neurological conditions facing women.

"Neurological conditions, such as epilepsy, can be more challenging to treat in women because of hormones and reproductive issues," said Elizabeth E. Gerard, MD, neurologist at Northwestern Memorial Hospital and assistant professor of neurology at Northwestern University Feinberg School of Medicine. "More research is needed to understand how neurological conditions affect women compared to men so that we can more effectively treat our female patients."

While the Women's Neurology Center is one of only a small number of women-focused neurology programs in the country, recent research indicates that gender plays a significant role in neurological conditions:

• Twenty percent of women suffer from migraines.
• Hormones affect seizure frequency in 30 percent of women with epilepsy.
• Sleep disorders in women are often overlooked by primary care physicians.
• Women are three times more likely than men to be diagnosed with multiple sclerosis.
• Stroke mortality is higher in women, although 30 percent of women are unaware of their stroke risk factors.
• Medications used to treat neurological disorders may have significant impact on pregnancy and contraception effectiveness.

The center offers patients treatment from sub-specialist neurologists with expertise in epilepsy, stroke, multiple sclerosis, migraine, headaches, dizziness, and sleep disorders. With an emphasis on incorporating an integrated medicine approach to patient care versus one based solely on pharmacology, the center also addresses reproductive health and issues related to women's hormones. Along with patient care, research will be a strong component of the Women's Neurology Center.

"We're excited to work with this very unique population that hasn't really been studied in depth," said Yvonne M. Curran, MD, a neurologist at Northwestern Memorial and assistant professor in neurology at the Feinberg School. "Women's health has been an under-appreciated field, but that is changing and patients who choose to come to this center will be helping to move this field forward."

For O'Shea, finding the right physician was exactly what she needed to get her epilepsy back in order.

"My epilepsy has never been so severe that I needed daily attention from a doctor what I was really seeking was someone who can counsel me in the next steps of my life, like contraception and family planning," explained O'Shea, who is now 24 years old and resides in Chicago.

"Since I started seeing Dr. Gerard, I haven't had another seizure. She makes me comfortable and gives me the information I need to make decisions about my health. In the past, doctors have made me feel scared or worried, but she makes me feel like I will be able to lead a completely normal life. I really feel like we're the perfect patient-doctor match."

O'Shea's story is a prime example of what the center seeks to do for women - not only managing their condition, but also providing counsel during different stages in their life and addressing how it may impact their neurological health.

"When a woman is diagnosed with a neurological condition, we need to take her through issues related to contraception, hormones, pregnancy and menopause," said Gerard. "This takes extra time and experience that our center is prepared to handle. Younger women need to be educated about how their neurological condition will affect pregnancy and contraceptive choices. Mature women need to be especially cognizant of how their symptoms may change during menopause."

Attribution/Source(s):
This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its significant relevance to the disability community. Originally authored by Northwestern Memorial Hospital, and published on 2013/02/18 (Edit Update: 2021/05/25), the content may have been edited for style, clarity, or brevity. For further details or clarifications, Northwestern Memorial Hospital can be contacted at nm.org. NOTE: Disabled World does not provide any warranties or endorsements related to this article.