Epilepsy
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Epilepsy is a state where seizures occur repeatedly without a known cause. Overall, patients fall into three broad categories in terms of response:

  • About half will respond to the first medication they are given and do just fine.
  • Approximately one-third will move on to another drug and need several treatments to achieve control.
  • Approximately one-sixth never become controlled no matter what we do.
  • Anxiety disorder is as high as 25 percent and depression up to 30 percent in patients with epilepsy.
  • More than a third of epilepsy patients with depression are neither evaluated nor treated. Untreated depression adds significant burden to the seizure patient with economic and psychosocial consequences.
  • Migraines occur at a higher rate in persons with epilepsy.
  • Specific issues exist for women of childbearing age, as well as menopausal women.
  • Estrogen has a pro-seizure effect. Epileptologists do not routinely recommend stopping estrogen therapy unless absolutely indicated, but they do add medications to offset the extra seizures.
  • Oral contraceptive therapy needs to be addressed specifically as significant drug interaction occurs. Please address this with your physician.
  • There is a 2 to 3 percent risk of birth defects in the general population, versus 4-6% among women with epilepsy with epilepsy taking anticonvulsants.
  • Elderly patients are more likely to require lower doses. Side effects of medications are more likely in the elderly due to the aging brain's vulnerability to sedation, tremors, and visual disturbances.

Associated symptoms and disorders

  • Anxiety disorder is as high as 25 percent and depression up to 30 percent in patients with epilepsy.
  • More than a third of epilepsy patients with depression are neither evaluated nor treated. Untreated depression adds significant burden to the seizure patient with economic and psychosocial consequences.
  • Migraines occur at a higher rate in persons with epilepsy.
  • Specific issues exist for women of childbearing age, as well as menopausal women.
  • Estrogen has a pro-seizure effect. Epileptologists do not routinely recommend stopping estrogen therapy unless absolutely indicated, but they do add medications to offset the extra seizures.
  • Oral contraceptive therapy needs to be addressed specifically as significant drug interaction occurs. Please address this with your physician.
  • There is a 2 to 3 percent risk of birth defects in the general population, versus 4-6% among women with epilepsy with epilepsy taking anticonvulsants.
  • Elderly patients are more likely to require lower doses. Side effects of medications are more likely in the elderly due to the aging brain's vulnerability to sedation, tremors, and visual disturbances. 

Nerve stimulator for epilepsy management

A Vagus Nerve Stimulator is a surgically implanted device used for seizure control. This service is available at Sinai Grace hospital.  Dr. Robert Johnson or Dr Tessy Jenkins for more information.


For more information about DMC Sinai-Grace Hospital’s neurology services or a referral to a Sinai-Grace neurologist, call 313-966-4800.