Female Issues in Epilepsy: A study of Women Living with Epilepsy in Kano, North-western Nigeria

Abstract

Background: Women with epilepsy require special consideration for several reasons, for example the sex hormones that subserve reproductive function like fertility and menstrual cycle have a direct influence on the excitability of the cerebral cortical neurons. Moreover, sexual dysfunction, infertility and menopause in women with epilepsy are important co morbidities with significant impact on their quality of life. In spite of these peculiarities there is paucity of data on women living with epilepsy in Northwestern Nigeria. This study describes the clinical profile of epilepsy among adult females and evaluates aspects of epilepsy peculiar to female gender. Methodology: This is a descriptive study of consecutive female patients with eipilepsy aged 14 years and above, seen at the adult Neurology Clinic of Aminu Kano Teaching Hospital (AKTH)and Murtala Specialist Hospital (MMSH) Kano over a period of 2 years. Questionnaire assessing demographic data, seizure type, frequency of seizure, antiepileptic drugs (AEDs) as well as issues peculiar to females was administered. Results: One hundred and two female patients were studied. Their age ranged between 14 and 85, mean age of 37 years (s.d = 16). The commonest type of epileptic seizure was primarily generalized. Thirty (29.4%) had menstrual irregularity, menstrual period precipitated attack in 10 (9.8%) patients, frequency of attack changed during menstruation in 24 (23.5%) patients, 34 (33%) of the patients admitted to change in sex desire; 15 (14.7%) women reported fertility problem. Twelve (11.8%) had history of OCPs use. Change in frequency of attack of epileptic seizure during pregnancy was recorded in 23 (22.5%) patients.; 55 (53.9%) admitted to not taking AEDs during pregnancies, 1(0.98%) patient reported birth defects, 11 of the menopausal women reported a reduction in frequency of seizure attacks on attaining menopause. Conclusion: In AKTH and MMSH, Kano, among women with epilepsy, generalized epileptic seizure was commoner than partial epileptic seizure .Menstrual disturbance, reproductive and menopausal misgivings as well as change in frequency of seizure were often reported.

Key Words Epilepsy, Kano, Women