How to manage seizures in a female at the age of 30?

Question

Hello doctor,

I am a 30-year-old woman who has experienced a few seizures over the past year, and I have recently been started on anti-seizure medication. I am concerned about:

Do I need to take these medicines for life?
Are there safe options available for women who are planning a pregnancy?
Do seizure medications interfere with birth control pills?
I would also like to know which daily activities I should avoid, such as swimming, driving, or even working in the kitchen alone.
Are seizures influenced by hormonal changes, and should I track my menstrual cycle to look for patterns?

Please help.

Thank you in advance.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

You have asked very important and practical questions. Let me explain them clearly:

1. Duration of medicines:Not all patients need lifelong anti-seizure medication. If seizures are well controlled for two to five years and the EEG (electroencephalogram, a test that records brain activity) and brain scans are stable, the doctor may consider gradually tapering the medicines. However, some people do require long-term treatment, especially if there is a structural problem in the brain or repeated seizures.

2. Safe options for women and pregnancy:Yes, some anti-seizure medicines are safer in pregnancy. For example, Lamotrigine and Levetiracetam are commonly prescribed because they are considered safer for the developing baby. Others, such as Valproate (also called valproic acid), are avoided as they can cause harm to the baby. If you are planning a pregnancy, it is very important to discuss this with your neurologist in advance so that your medicines can be adjusted safely.

3. Effect on birth control pills:Some seizure medicines like Carbamazepine, Phenytoin, Phenobarbital, and Topiramate (when used in high doses) can reduce the effectiveness of birth control pills, making them less reliable. In such cases, your doctor may recommend safer contraception methods or adjust your medicines.

4. Daily activities to avoid:

Driving: Usually restricted until you have been seizure-free for six to 12 months (rules vary depending on the country).
Swimming or bathing: Should always be done under supervision. Avoid being alone in deep water or locking yourself in the bathroom.
Cooking: Be cautious with open flames or boiling water. Safer alternatives include using a microwave or an induction stove.
Climbing heights or operating heavy machinery: These should be avoided until seizures are under complete control.

5. Hormonal influence:Yes, in some women, seizures are linked to the menstrual cycle. This is called catamenial epilepsy (a condition where seizure frequency increases around menstruation due to hormonal changes). Tracking your menstrual cycle along with seizure timing can help identify a pattern, and your doctor may adjust treatment accordingly.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.