By James Santiago Grisolía, MD
Epilepsy creates major health burdens for the Latino community. Women’s Health Month reminds us of the advances and continued challenges for Latinas with seizure disorders.
Our brains depend on electrical circuits of brain cells to let us think, feel and move. Many disorders (stroke, head trauma, drugs and alcohol, genetic conditions) can short out these circuits, causing excessive sparking of brain cells. This results in seizures that range from brief staring spells to blackouts with strong shaking of all limbs. During our lives, 10% of all people will suffer at least one seizure and 1% of us will have more than one, qualifying for a diagnosis of epilepsy.
Most people with epilepsy have normal intelligence and abilities, although a few can have learning disabilities, cerebral palsy or other problems. Many new medicines are available, so that most people can control their seizures without side effects. However, women with epilepsy have many special issues, including the effects of seizure medicines on sexuality, contraception, fertility, menstruation, and pregnancy. The Epilepsy Foundation of San Diego provides information and referrals at 619-296-0161, and detailed information in English or Spanish can be downloaded from the Foundation website at www.epilepsysandiego.org, through links to the national website. A new, comprehensive book for consumers called “Women and Epilepsy” by Martha Morrell, MD is available in English on the national website or through Amazon.com.
Women with epilepsy usually have normal babies, but it is vitally important to select the best medicines and start a special vitamin called folic acid BEFORE getting pregnant. This reduces the risk of birth defects due to the seizures or the medications. Consult a neurologist or obgyn doctor before pregnancy. The SD County Medical Society provides doctor referrals at 858-565-8888, and has a special program called Reach Out for the uninsured. UCSD maintains a Teratogen Hotline with information on medicines and birth defects at 619-543-2040.
Additionally, birth control pills can be inactivated by some seizure medications but not others. Women with epilepsy should discuss with their doctors, to find the best contraception method for them.
The Latino community suffers special problems with access to care, including lack of health insurance, language and cultural barriers. Some years ago, the Epilepsy Foundation surveyed the Mexican community of San Diego and found many people have wrong information, thinking that epilepsy comes from spiritual or mental illness. “Natural” treatments and curanderismo do not work for epilepsy.
Many people receive health care on both sides of the border. While the latest information on women and epilepsy is more available in the U.S., many seizure medicines are cheaper in Mexico. Currently, it is legal to cross the border with medication for personal use, but it is safest to bring a prescription from a U.S. doctor to prove the medicine is needed.
Mexican brands of phenytoin (Dilantin) are not reliable, but most people can safely use other Mexican seizure medicines. Consult your doctor about whether buying medicine in Mexico will be safe for your particular case.
Dr Grisolía is Chief of Neurology at Scripps-Mercy Hospital and serves on the Board of the Epilepsy Foundation of San Diego.