Authors :
First Author: Carmela Redhead, BSc, BScN, RN – London Health Sciences Centre
Presenting Author: Ana Suller Marti, MD, MSc, PhD – Western University
Jayme Arts, BA – Research Coordinator, Clinical Neurosciences, London Health Sciences Centre; Panagiota Tryphonopoulos, PhD – Assistant Professor, Arthur Labatt Family School of Nursing, Western University; Michelle-Lee Jones, MDCM, FRCPC, CSCN (EEG) – Neurologist, Clinical Neurosciences, London Health Sciences Centre; David Diosy, MD, FRCPC – Neurologist, Clinical Neurosciences, London Health Sciences Centre; Jorge Burneo, MD, MSPH, FAAN, FAES, FRCPC – Neurologist, Clinical Neurosciences, London Health Sciences Centre; Seyed Mirsattari, MD, PhD, FRCPC – Neurologist, Clinical Neurosciences, London Health Sciences Centre; Ana Suller Marti, MD, MSc, PhD, FRCPC – Neurologist, Clinical Neurosciences, London Health Sciences Centre
Rationale: Women with epilepsy (WWE) face difficulties with fertility, family planning, contraception, teratogenicity, management during and after pregnancy, safety while caring for children, hormonal influences on seizure frequency, and bone health. There is very little research on whether WWE receive the recommended care during these times. The aim of this study is to evaluate whether WWE receive the care recommended in provincial guidelines and by epilepsy experts for gender-specific and sex-specific health issues from the perspective of the WWE.
Methods:
A Canadian cross-sectional anonymous survey open to patients seen in Epilepsy Clinic or admitted to the Epilepsy Monitoring Unit at London Health Sciences Centre with a history of epilepsy and who identify as a woman or who were assigned the female sex at birth was launched in December 2022. Participants were 18 years old or older.
Results:
Preliminary results of 80 participants, mean age of 37.2 (range 18-66). Of the WWE who reported menses affecting their seizure frequency, 81% (n=21) discussed this with their physician, with no treatment changes for 70.6% (n=17). Only 37.7% (n=69) of WWE use contraception, of which 38.5% (n= 26) use IUDs and 23.1% (n=26) use hormonal contraceptives. 63.2% (n=68) were advised to take folic acid, of which 25.6% (n=43) use 1mg and 25.6% (n=43) use 5mg. Half (n=38) of pregnancies were unplanned. 39.5% (n=38) of WWE who have been pregnant were diagnosed with a mental health condition before pregnancy and 30.6% (n=36) were screened for postpartum mood disorders. 47.1% (n=34) breastfed their children and 35.3% (n=34) discussed the safety of using antiseizure medications while breastfeeding with a physician. 88.5% (n=61) of participants were not diagnosed with a bone condition, 61.7% (n=60) were advised to take vitamin D, 28.3% (n=60) were advised to take calcium supplements, and 35% (n=60) received no bone health counselling.
Conclusions: WWE are receiving care and counselling for sex-specific and gender-specific health issues in some areas (e.g., bone health and folic acid use), but not in others (e.g., contraception and postpartum mood disorder screening). In some areas, such as the relationship between menstruation and seizure frequency, most WWE receive counselling but there is no change to their care plan. Continued research and training are needed to improve the care WWE receive.
Funding: N/A