Brief Communication Women and epilepsy

Epilepsy affects about 45 million people worldwide. Incidence is highest among young children and the elderly, and men are affected slightly more often than women (1.5:1) (1). In the United States, age-adjusted annual incidence rates based on 1990 census figures range from 31 to 57 per 100,000 population (2). Cause and seizure type vary with age. Excluding febrile seizures or those related to an acute illness, the lifetime likelihood of someone experiencing at least one seizure is about 10%. The risk of epilepsy development, however, is lower, about 3 to 4 % emphasizing that not all seizures lead to epilepsy (3). In fact, about 30 % of persons with unprovoked seizure types, such as absence, myoclonic, and complex partial, are virtually always recurrent by time a physician is consulted (4). Because people with a single seizure do not have epilepsy and may not require long term antiepileptic drug treatment, it is important to determine whether a first unprovoked seizure is likely to lead to further attacks. Unfortunately, the ability to do this is not always easy (5,6). Persons with epilepsy have increased mortality rates compared with the general population. Most of this increased risk occurs in patients with symptomatic epilepsy in whom mortality relates to the underlying condition. In patients with idiopathic or cryptogenic epilepsy, the increased risk of death is related mainly to accidents, especially drowning although sudden unexpected death can occur. Autopsy and clinical series have demonstrated an increased risk of sudden unexplained death among epileptic patients (7). Obstetric complications associated with epilepsy 1. Increase the risk of vaginal bleedin