Special situations in epilepsy: women and the elderly

The treatment of epilepsy requires special considerations for certain groups of patients. In this review we will address some of these situations, such as epilepsy in women and the elderly.

Epilepsy in women has specific implications, because a significant proportion of women will present epilepsy during reproductive age, affecting contraception, pregnancy, fetal development, and lactation. Moreover, the influence of sex hormones on the evolution of epilepsy is known, as well as the effects of treatment with antiepileptic drugs on fertility, endocrine function and possible adverse effects on weight, to say nothing of cosmetic aspects, sexual function, and bone metabolism. All these factors must be taken into account in the treatment and monitoring of women with epilepsy. The incidence of epilepsy is greater in the elderly than in other population groups and is under diagnosed. The special characteristics of this population, such as the presence of concomitant diseases or greater sensitivity to adverse effects, requires a thorough knowledge of the different options of antiepileptic drugs for each situation.

This article reviews the different types of epilepsy most frequently observed in the elderly, etiology, clinical symptoms, diagnosis, prognosis, and treatment.