Age-Related Counseling Requirements for Women with Epilepsy

Women with epilepsy (WWE) have varying concerns at different ages and require relevant counseling and management. We conducted a retrospective chart review of WWE seen at the specialized women's epilepsy clinic at Westchester Medical Center (WMC) from May 2024 to June 2025.

We included patients 18 or older assigned female at birth referred for epilepsy evaluation and management. There were 117 patients who were subdivided into the age groups of 18-30, 31-44, and above 45 years old. 65.9% of patients received care related to the management of seizures or epilepsy, whereas 23% were found to have seizure mimics such as syncope, tremors, migraines, or transient ischemic attacks, and 11% were identified as functional seizures or functional neurological disorder. Our results show that 22% of patients with epilepsy on antiseizure medications (ASMs) had never received contraception counseling, 48% were unaware of fetal malformation risks from ASMs and the benefit of folic acid supplementation, and 71% had not been counseled on bone health.

Women seen in a specialized women's epilepsy clinic at WMC demonstrated distinct age-related concerns. Younger patients focused on reproductive health, whereas older patients prioritized comorbidities and seizure mimics. Unlike prior data, patients aged 31-44 and 45 and above had greater counseling needs than the 18-30 age group transitioning from pediatric care. These findings support the need for age-specific epilepsy counseling and targeted counseling to improve patient compliance. This study underscores the need for a specialized epilepsy clinic in addressing both medical and psychosocial aspects of care for WWE.