Epilepsy and women

Epilepsy is a common neurological disorder that is characterized by recurrent and unprovoked seizures. The seizures are transient signs or symptoms of abnormal and excessive neuronal activity in the brain. A large percentage of people all over the world have epilepsy, and it usually occurs in young children or the elderly. This disease is usually controlled, but it is not fully cured with medication. Surgery can be an option but not for all cases. The syndrome of epilepsy will not occur lifelong; some forms are just confined in the early childhood of the affected person. This disease should not be understood as a single disorder but rather as a group of syndromes that has divergent symptoms but all of them involve electrical activity in the brain.

Epilepsy and Women’s Hormones

Women with epilepsy are a special case, and it requires some considerations because of the relationship between the female sex hormones—the estrogen and the progesterone—and the seizures. There are some women who experience fluctuating seizures because of the differences in the amount of hormone present in the body. Some significant times in a woman’s life where hormonal changes are observed are during her puberty stage, during pregnancy, and during the menopausal stages.

Estrogen and progesterone regulate the menstrual cycle, and they prepare the women’s body for reproduction. Estrogen can excite the electrical activity of the brain and increase the risks of seizure, while progesterone suppresses the electrical activity and reduces seizure risks. The two can be balanced for most times, but when an imbalance occurs where more estrogen is produced than the progesterone, women with epilepsy will have high risks of seizure.

Epileptic Women and Pregnancy

There are some important things that an epileptic woman should know first before using any birth control pills and planning on a pregnancy. Birth control pills are safe for a woman with epilepsy, but there are also some conditions in which the use of birth control pills are risky because they can be rendered less effective when anti-seizure drugs are also taken. Anti-seizure drugs can increase the risk of birth defects. There are many anti-seizure drugs and medications that can be used as birth control and hormonal pills that have no ill effects on child bearing. These drugs are:

1).One group of anti-seizure drugs is known as “liver enzyme-inducing” drugs. They increase the rate at which the liver breaks down the contraceptive hormones that you get from birth control. This means that the contraception medication will leave your body faster. Liver enzyme-inducing drugs include oxcarbazepine (Trileptal), carbamazepine (Carbatrol, Tegretrol), phenytoin (Dilantin), phenobarbital (Luminal), primidone (Mysoline), and topiramate (Topamax). If you are taking one of these drugs, it can make your hormonal birth control less effective.

2).Two drugs—felbamate (Felbatol) and valproate (Depakote)—can even heighten the hormonal levels. If you are on one of these drugs, your doctor may need to adjust the dosage of your birth control so that you don't have too much of the contraceptive in your body.

3).Finally, there are “neutral” drugs that do not have any effect on hormone breakdown. Lamotrigine (Lamictal), gabapentin (Neurontin), levetiracetam (Keppra), clobazam, clonazepam, ethosuximide, Lyrica, sodium valproate, Zonegran, and tiagabine (Gabitril) will not interfere with your birth control.