Authors :
Presenting Author: Preeti Puntambekar, MD, PhD, FACNS, FAES – Westchester Medical Center Health Network, New York Medical College, Valhalla, NY, USA
Kourtney Kelly, BS – New York Medical College- Valhalla, NY
Lior Zweig, BS – New York Medical College, Valhalla, NY
Lauren Grobois, MD – Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai
Rationale:
To understand the primary concerns of women who present to a specialized clinic for women with epilepsy at Westchester Medical Center (WMC).
Methods:
This retrospective chart review includes all women with epilepsy (WWE) seen at the women’s epilepsy clinic at WMC from May 2024–June 2025. Based in suburban NY, WMC is uniquely located and serves both urban and rural populations. Inclusion: female-identifying patients, 18 or older referred for epilepsy evaluation and management. Data on demographics, epilepsy history, chief complaint, counseling, and management were collected.
Results:
Of the 88 patients who presented to the clinic during this time period, 29 were between the ages of 18-30, 19 ages 30-45 and 40 above 45 years old. 80.7% patients received care related to management of seizures or epilepsy whereas 19.3% received care related to a likely diagnosis of Functional Neurological Disorder (FND), syncope, tremors, or another neurologic event. Patients ages 18-30 primarily presented for preconception counseling, peripartum seizure management, epilepsy syndromes, and transition of care from a pediatric neurologist. Patients ages 30-44 mainly presented for peripartum seizure management and general management of epilepsy. Of note, many of these patients mentioned familial stressors during these visits. Patients ages 45+ presented most commonly with post-menopausal seizure management, memory loss, neurocognitive concerns, cancer diagnoses, syncope, tremors, and multi-medication management. Of the patients with epilepsy on anti-seizure medications, 14/35 (40%) had never received contraception counseling, 9/35 (26%) were unaware of fetal malformation risks from anti-seizure medications and folic acid supplementation, and 27/35 (77%) had not been counseled on bone health.
Conclusions:
Women seen in a specialized women’s epilepsy clinic at WMC demonstrated distinct age-related concerns. Younger patients focused on reproductive health, while older patients prioritized comorbidities and seizure mimics. These findings support prior studies highlighting the need for age-specific epilepsy counseling. Targeted counseling improved patient compliance in our population. Caregivers participated when needed, and intellectual disability did not affect counseling delivery. The prevalence of FND remains high for our clinic patients. Unlike prior data, patients aged 30-45 and >45 had greater counseling needs than the 18–30 age group transitioning from pediatric care1,2. This study underscores the need for targeted interventions, age-related counseling requirements and the role of a specialized epilepsy clinic in addressing both medical and psychosocial aspects of care for women with epilepsy.
1. Camfield P, Camfield C, Pohlmann-Eden B. Transition from pediatric to adult epilepsy care: a difficult process marked by medical and social crisis. Epilepsy Curr. 2012 Jul;12(Suppl 3):13-21. PMID: 23476118
2. Smith CC, Curcio AM, Grinspan ZM. Reproductive Health Counseling in Adolescent Women With Epilepsy: A Single-Center Study. Pediatr Neurol. 2022 Jun; 131:49-53. PMID: 35489277
Funding: None