Myths about women with epilepsy

Cause and effect
All seizures happen because of a sudden change in the way the brain cells send electrical signals to one another. Most seizures are categorized as either partial or generalized. Partial seizures describe those that occur when there's a disturbance in one area of the brain, such as in the temporal lobe. Symptoms may include unusual sensations, hallucinations involving vision or smell, dizziness or jerky movements of one part of the body. A person experiencing such a seizure may or may not lose awareness of her surroundings.

Generalized seizures occur when the electrical disturbance involves the entire brain. There are several types of these, such as an absence seizure, during which a person loses awareness and may appear to be blinking and starring into space, and a tonic-clonic seizure, which is characterized by a person falling, muscles stiffening and the whole body convulsing.

Lynn Foeller, 44, was diagnosed with epilepsy and experienced tonic-clonic seizures when she was six years old. She has experienced absence seizures throughout her life, and in 1999 the tonic-clonic seizures reappeared. She was under a lot of stress at the time, which is a common trigger. Other triggers include failure to take epilepsy medication, lack of sleep, illness or fever, excessive use of or withdrawal from alcohol and use of illegal drugs.

"There are a lot of misconceptions about epilepsy," says Lynn, who lives in Cobourg, Ont. "Just because someone has epilepsy doesn't mean she's going to fall down and lose control." Lynn has kept her epilepsy a secret because of such misunderstandings. "If people didn't know what they were looking for, they wouldn't pick up on it," she says. But things changed with the return of the tonic-clonic seizures, which she experienced on her way to work one morning. She stopped working because it was too dangerous for her: she worked as a lab technician and regularly handled acids; she walked up 20 concrete stairs each day and falling could cause an injury; and she was struggling with temporary memory loss, a common side-effect of anti-epileptic drugs (AEDs).

Lynn also takes precautions in her personal life. After a tonic-clonic seizure, for example, she avoids visiting friends because her vocabulary is confused for a few days. She never drives or uses anything sharp, such as an electric knife or her husband's electric tools. She never climbs a ladder or swims in the pool without her husband close by.

Jetté says people with epilepsy can take part in most activities, though it can depend on the type of seizures they experience. All people with seizures involving loss of consciousness should avoid taking a bath, swimming alone, scuba diving and height-related activities, such as rock climbing. But an activity they shouldn't be afraid of is starting a family.

Family planning
Shawna's seizures began two years after the birth of her first son, but she didn't let the epilepsy stop her from having two more healthy children. But there are risks that women with epilepsy must consider before starting a family.

Dr. Eva Andermann is the director of neurogenetics at the Montreal Neurological Institute and Hospital and a professor in the departments of neurology and neurosurgery and human genetics at McGill University in Montreal. For more than 30 years she has been studying the outcomes of pregnancy in women with epilepsy who are also taking AEDs. During a study recently presented to the American Epilepsy Society, 96 children between the ages of six and 16 and born to mothers with epilepsy were monitored. Andermann says that while the numbers aren't big enough to determine the effects of all the different AEDs (there are close to 20 epilepsy medications on the market), many of these children's IQs are eight to 10 points lower than average. She says it's important to "minimize the number of drugs because overall it seems the decreased IQ is more related to the drugs than the seizures or the epilepsy." Andermann adds that a woman with epilepsy needs to discuss medication and family planning with her neurologist at least six months before trying to get pregnant.

As far as Shawna can determine, her epilepsy medication has had no effect on her kids -- Jonathon, Mark and Breann. "Epilepsy will change your life," she says, "but you can still have a family, career or whatever it is that makes life fulfilling to you."

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