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Epilepsy Care in Transgender Patients

  • Epilepsy (C. Elder, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The goal of this review is to outline the main considerations when treating transgender patients with epilepsy. Points to be addressed include the gender affirming hormone therapy regimens and how they interact with anti-seizure medications and seizure control, as well as common co-morbidities in the transgender epilepsy population.

Recent Findings

Gender affirming hormone therapy (GAHT) may affect seizure control directly, due to proconvulsant or anticonvulsant properties. GAHT may interact with anti-seizure medications; most notably, estrogen will decrease serum concentration of lamotrigine. Enzyme-inducing anti-seizure medications may decrease hormone levels, potentially interfering with goals of GAHT. Transgender epilepsy patients are at risk for co-morbidities such as decreased bone mineral density and depression.

Summary

There are minimal direct studies on treatment or outcomes in the transgender epilepsy population. Providers must be knowledgeable about the bi-directional interactions between gender affirming hormone therapy and anti-seizure medications, as well as direct hormonal influences on seizure control. Future research should directly evaluate outcomes in transgender epilepsy patients with regard to seizure control, success of hormone therapy, and management of co-morbidities, to further educate providers and patients how to best manage their healthcare.

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Authors and Affiliations

  1. Department of Neurology, Columbia University, 710 W. 168th Street, 7th floor, New York, NY, 10032, USA

    Genna Waldman & Rachael Benson

  2. New York Presbyterian Hospital, 630 West 168th Street , New York, NY, 10032, USA

    Genna Waldman

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  1. Genna Waldman
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Correspondence to Rachael Benson.

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Waldman, G., Benson, R. Epilepsy Care in Transgender Patients. Curr Neurol Neurosci Rep 22, 451–458 (2022). https://doi.org/10.1007/s11910-022-01208-4

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