Epilepsy Care for Adolescents of Reproductive Age (EPI-CARE)

Adolescents with epilepsy face unique health challenges, particularly around the impact of hormones on seizures and reproductive health. The EPI-CARE program at Boston Children’s Hospital provides comprehensive evaluation and counseling for reproductive-aged youth with epilepsy, combining the expertise of adolescent medicine and epilepsy specialists.

EPI-CARE focuses on the unique health needs of patients assigned female at birth, ages 12 to 21, who have a diagnosis of epilepsy. This includes patients with intellectual and neurodevelopmental disabilities.

Our team specializes in reproductive health, including menstrual seizures (catamenial epilepsy), interactions between anti-seizure medications and contraceptives, and pregnancy planning. We also provide support for menstrual cycle management and behavioral and mood changes during periods. We recognize that hormonal fluctuations can impact mood and seizure control, so we offer strategies to manage symptoms such as irritability and anxiety.

We take a holistic approach to care, working with Endocrinology, Adolescent and Young Adult Medicine, Nutrition, Epilepsy Genetics and genetic counseling, and Psychiatry to address the physical, emotional, social, and developmental needs of adolescents of reproductive age who have epilepsy. To ensure continuity of care, we work closely with adult epilepsy specialists to help patients transition smoothly into adulthood without gaps in care as they mature out of pediatric epilepsy programs.

We value our partnerships with referring physicians to improve care for reproductive-aged youth with epilepsy. EPI-CARE offers consultations and counseling for patients and their families without requiring a transfer of care, enhancing the routine support provided by neurologists and primary care physicians. We focus on discussing hormonal medications for specific menstrual disorders, the potential effects of seizure medications on future pregnancies, managing seizures that may worsen during menstruation, and addressing mental health concerns. Furthermore, we collaborate with the Women’s Epilepsy Program at Brigham and Women’s Hospital to ensure a seamless transition to specialized adult care for our patients.

Learn more about referring patients.

Alongside our local efforts, we’re proud to be part of the Epilepsy in the Child-Bearing Ages through Menopause Consortium (ECAM), an international collaboration to improve research and clinical care for women with epilepsy. As part of the ECAM’s Adolescent and Young Adult Committee, we help guide neurologists who counsel adolescents and young adults with child-bearing potential about reproductive health.