Women

Women with epilepsy may face additional complications because of the relationship between the female sex hormones (estrogen and progesterone) and seizures. Some girls with epilepsy find that their seizures stop or become more frequent when they enter puberty. In addition, many women experience changes in the pattern and frequency of their seizures during menstruation and menopause (the end of menstruation). This interplay between hormones and seizures can result in several lifestyle considerations related to the following:

• Birth control methods, especially the contraceptive pill
  
• Conception and pregnancy
  
• Postnatal care
  

Children and teenagers

A diagnosis of epilepsy may be particularly distressing for children and teenagers. It may be difficult for parents to explain to their child why the seizures are occurring, especially if a physician has had difficulty identifying their cause. It is important that parents be honest with their child about the condition and how it may affect the child’s life. Parents should encourage children with epilepsy to share their feelings, especially those experienced before, during and after a seizure. Children with epilepsy should be encouraged to report any changes in the intensity or frequency of their seizures.

Children should be allowed to take responsibility for their seizure medications as soon as possible. Although parents or guardians should monitor the child’s compliance, children who understand when and why they must take their medications are less likely to stop taking their seizure medications. This can help them control their seizures into adulthood (if necessary).  

Parents of children with epilepsy should be aware of possible side effects of medications their child is taking. It is particularly important that parents be able to identify any signs of depression or anxiety, which can affect how a child is able to cope with their epilepsy throughout life.

Parents should talk with teachers, coaches and other relevant school personnel about the nature of their child’s epilepsy and what action should be taken in the event of a seizure.

Most children with epilepsy do not experience reduced intelligence or brain damage and should be able to perform most tasks requested of them at school. However, some types of seizures, especially if they are poorly controlled, may disrupt everyday learning. Parents may ask that reasonable accommodations be made for their child, such as extra time to complete tests or extra help to enable them to catch up after absences.

Although parents should ensure that their child is safe to the best of their ability, it is important for the child to be allowed to participate in activities with peers. Children with epilepsy should be under close supervision whenever swimming or playing around water, and should never be allowed to swim alone. However, most children with epilepsy can participate in team sports, including football, basketball and baseball.

Parents of children with epilepsy may have a tendency to overprotect their child. However, this type of parenting can cause difficulties later in life. Children who are sheltered from normal childhood experiences may grow up to be withdrawn and shy. It may affect their relationships as they develop into teenagers and adults as well as their employment prospects. The effects of a sheltered childhood are often experienced well into adulthood and may sometimes be felt after seizures have stopped.

Some treatment methods used primarily on children involve significant lifestyle changes. For example, there is evidence that a diet that is low in carbohydrates and protein but high in fat may help control seizures in children who have not responded well to medication. This type of diet, called a ketogenic diet, forces the body to enter a state called ketosis where it burns mostly fat to function. This mimics the process of starvation, which is thought to affect brain activity. However, it is not fully understood why or how the ketogenic diet works to control seizures in some children. The effectiveness of the diet among adults is unknown.

Parents who choose to place their child on the ketogenic diet must carefully construct meals that provide the correct proportion of fats, carbohydrates and protein. This involves precisely weighing or measuring food and drinks using a gram scale and restricting certain foods, such as those that contain sugar. Although this type of diet has been shown to be beneficial in controlling seizures, parents of children with epilepsy should consult their child’s physician about the potential side effects of the diet, which may include malnutrition, physical development problems, kidney stones and increased seizures if the diet is not precisely followed. The ketogenic diet should only be followed under the supervision of a physician familiar with the diet.

The elderly

Elderly people usually develop epilepsy as a result of brain damage sustained later in life. The most common causes of new onset epilepsy in elderly people are conditions that deprive the brain of oxygen (such as a stroke or heart attack). These cerebrovascular events are believed to account for over 30 percent of new cases of epilepsy in elderly people, according to the National Institute of Neurological Disorders and Stroke (NINDS). Additionally, conditions that cause degeneration of the brain, such as Alzheimer's disease, brain tumors or infections that affect the brain (e.g., meningitis) may lead to epilepsy.

Lifestyle considerations are complex for elderly people with epilepsy. This is because epilepsy is likely to be just one of several medical conditions an elderly person may have, making them even more susceptible to adverse interactions and/or side effects. For example, elderly people are more likely to experience side effects of seizure medications that include confusion, unsteadiness and fatigue. This may be due to adverse interactions between seizure medications and other medications they are taking. It may also be because seizure medications do not pass as quickly through the bodies of elderly patients as they do in younger patients. This can make it difficult for elderly people to control their seizures, which can hinder their ability to live independently.

Additionally, some of the natural effects of aging can make it hard to control seizures. For example, elderly people who experience memory loss may have trouble remembering whether they have taken their seizure medication. Also, elderly people may have problems establishing regular sleep schedules as their need for sleep changes.

Elderly people with epilepsy may be able to reduce the risk of seizure-related accidents and live independently for longer by taking certain steps to ensure that they are safe in their homes. These steps may include avoiding sources of heat, such as a stovetop, iron or heater with exposed heating elements or that can be tipped over. Instead, elderly people with epilepsy should use the microwave oven for cooking or boiling water. They should also avoid anything that may be dangerous if a person temporary loses control of their muscles (e.g., electric knives). Elderly patients with epilepsy should avoid smoking (to prevent a fire) or bathing in high levels of water (to prevent accidental drowning).

Elderly people with epilepsy can avoid injuries by installing carpet over wood or tile floors and by covering hard furniture with padding. Living in a home without stairs also helps avoid accidents that may occur in elderly people with epilepsy. Portable phones or beepers may make it easier to call for help from any area of the home.

Driving skills tend to decline with age. Elderly people with epilepsy and poorly controlled seizures may be even more likely to cause vehicular accidents than those without the condition, and therefore may benefit from public transportation or other forms of assistance.