Epilepsy Care in Transgender Patients

Waldman, Genna; Benson, Rachael

doi:10.1007/s11910-022-01208-4

Cited by 6 publications

(4 citation statements)

References 42 publications

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“…Regular screening of vitamin D levels and bone health with dual-energy X-ray absorptiometry should be obtained due to increased risk for osteoporosis. 75,78 Special considerations are needed for those with treatment-resistant epilepsy on multidrug regimens due to interactions with GAHT.…”

Section: Treatment Considerationsmentioning

confidence: 99%

“…Estradiol can increase the metabolism of ASMs by inducing glucuronidation, particularly of lamotrigine and to a lesser degree valproic acid. 75…”

Section: Epilepsymentioning

confidence: 99%

“…Estradiol can increase the metabolism of ASMs by inducing glucuronidation, particularly of lamotrigine and to a lesser degree valproic acid. 75 Estrogen and testosterone are important for bone health. People with epilepsy are at risk for seizure-related injuries.…”

Section: The Dynamic Interaction Between Antiseizure Medications and ...mentioning

confidence: 99%

“…The NIH Progesterone Trial found decreased seizure frequency in cisgendered women with catamenial epilepsy treated with progesterone. 75 Androgen effects are more variable due to testosterone metabolism to both estradiol, a proconvulsant, and androstanediol and dihydrotestosterone, both of which are anticonvulsants mediated by enhancing GABA-A receptor activity. A small trial investigating anastrozole, an aromatase inhibitor that reduces the conversion of exogenous testosterone to estrogen, in seven cisgendered men with epilepsy over a 12-week period resulted in a reduction in seizure frequency.…”

Section: Epilepsymentioning

confidence: 99%

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Neurological Health in Sexual and Gender Minority Individuals

Simmasalam,

Zuniga,

Hinson

2024

Semin Neurol

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Despite representing a significant proportion of the U.S. population, there is a paucity of population-based research on the health status and health needs of sexual and gender minority (SGM) individuals in neurology. Compared with heterosexual peers, some SGM populations have a higher burden of chronic health conditions. In parallel, SGM individuals are more likely to experience stigma and discrimination producing psychological distress, which may contribute to and be compounded by reduced health care access and utilization. In this narrative review, we summarize the existing literature on common neurological health conditions such as stroke, headache, epilepsy, movement disorders, and traumatic brain injury through the lens of intersection of SGM identity. Special focus is attuned to social determinants of health and gender-affirming hormonal therapy. Given the limitations in the available literature, there is an urgent unmet need for datasets that include sexual orientation and gender identity information, as well as funding for research that will characterize the prevalence of neurological conditions, unique risk factors, and health outcomes in SGM populations. In the health care community, providers should address deficiencies in their professional training and integrate inclusive language into their clinical skillset to build trust with SGM patients. There is an opportunity in neurology to proactively engage SGM communities, collaborate to remove barriers to care, promote resilience, and develop targeted interventions to ensure high-quality, culturally competent care for SGM populations to improve neurological health for all.

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Section: Treatment Considerationsmentioning

confidence: 99%

“…Estradiol can increase the metabolism of ASMs by inducing glucuronidation, particularly of lamotrigine and to a lesser degree valproic acid. 75…”

Section: Epilepsymentioning

confidence: 99%

Section: The Dynamic Interaction Between Antiseizure Medications and ...mentioning

confidence: 99%

Section: Epilepsymentioning

confidence: 99%

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