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Seizure Disorders in U.S. Latinos
Epilepsy & Behavior 1, 287–290 (2000) All articles available online at http://www.idealibrary.com on
LETTERS TO THE EDITOR Seizure Disorders in U.S. Latinos (AEDs) with their female patients. Furthermore, despite widely disseminated information about the importance of folic acid treatment before conception and during the first trimester of pregnancy, nearly onethird of the neurologists and one-half of the psychiatrists do not routinely recommend folate to their female patients who were planning to become pregnant. I believe that Latino patients with epilepsy, especially women and their future offspring, are being placed in jeopardy unnecessarily. We need to focus on identifying and meeting the needs of this group of patients. Dr. Grisolia’s editorial should be a wakeup call to us all.
To the Editor: I read with interest the editorial by Dr. Grisolia (1), which clearly presents the variety of problems encountered by Latino patients with epilepsy. Latino patients in Southern Florida may have a different ethnic mix than those in Southern California, yet their barriers to appropriate medical care are very similar. In both states, and many others, language and cultural beliefs about epilepsy impact the medical care received by Latinos. In particular, Latino women with epilepsy face significant difficulties. It is well known that women of lower socioeconomic status generally have poor prenatal care, higher incidence of teenage pregnancy, folate-deficient diets, poor compliance with medical treatment, higher rates of alcohol and drug abuse, and pregnancies complicated by higher morbidity and mortality rates. In addition, many Latino women with epilepsy also have misconceptions about what constitutes good seizure control, inadequate therapeutic regimens, and lack of counseling from their physicians about issues related to pregnancy. We conducted a survey of neurologists and psychiatrists in Dade County, Florida, on various aspects of the care and treatment of women with epilepsy. Dade County was selected because it has a sizable Latino population. A significant proportion of these specialists do not routinely discuss birth control, pregnancy, or the possible teratogenicity of antiepileptic drugs
REFERENCE 1.
Enrique J. Carrazana, M.D. 1 Neurologic Center of South Florida 8940 North Kendall Drive Suite 802-E Miami, Florida 33176 doi:10.1006/ebeh.2000.0084 1 To whom correspondence should be addressed. E-mail: [email protected].
To the Editor:
and the local Epilepsy Foundation affiliate. Our Hispanic population is probably more heterogeneous than Grisolia’s and this may account for some of the differences in our perspectives. We have encountered a strong sense of community and extended family in our Hispanic patients. Indeed, their family structure is often preserved despite severe, often intractable, seizures. Marriages often survive the hardships of this diagnosis, unlike the situation often encountered with other chronic illnesses. We have several male patients with epilepsy who assumed the role of househusbands as their wives support the family. Often, single patients will not only be allowed, but also encouraged to live with their parents or relatives into adult life.
We read with interest the article by Grisolı´a on seizure disorders in Latinos living in Southern California (1). The population in question seems to consist primarily of Mexican immigrants and their treating physicians. Spanish-speaking peoples of various nationalities contend that all Latinos are Hispanics but not all Hispanics are Latinos. Because of their diversity, members of the community in south Florida refer to themselves as Hispanics rather than Latinos. We take care of what is probably the largest population of Hispanics with epilepsy in south Florida through epilepsy clinics at the University of Miami 1525-5050/00 $35.00 Copyright © 2000 by Academic Press All rights of reproduction in any form reserved.
Grisolı´a JS. Epilepsy of the borderlands: seizure disorders in U.S. Latinos. Epilepsy Behav 2000;1;150 –2.
287
LETTERS TO THE EDITOR Seizure Disorders in U.S. Latinos (AEDs) with their female patients. Furthermore, despite widely disseminated information about the importance of folic acid treatment before conception and during the first trimester of pregnancy, nearly onethird of the neurologists and one-half of the psychiatrists do not routinely recommend folate to their female patients who were planning to become pregnant. I believe that Latino patients with epilepsy, especially women and their future offspring, are being placed in jeopardy unnecessarily. We need to focus on identifying and meeting the needs of this group of patients. Dr. Grisolia’s editorial should be a wakeup call to us all.
To the Editor: I read with interest the editorial by Dr. Grisolia (1), which clearly presents the variety of problems encountered by Latino patients with epilepsy. Latino patients in Southern Florida may have a different ethnic mix than those in Southern California, yet their barriers to appropriate medical care are very similar. In both states, and many others, language and cultural beliefs about epilepsy impact the medical care received by Latinos. In particular, Latino women with epilepsy face significant difficulties. It is well known that women of lower socioeconomic status generally have poor prenatal care, higher incidence of teenage pregnancy, folate-deficient diets, poor compliance with medical treatment, higher rates of alcohol and drug abuse, and pregnancies complicated by higher morbidity and mortality rates. In addition, many Latino women with epilepsy also have misconceptions about what constitutes good seizure control, inadequate therapeutic regimens, and lack of counseling from their physicians about issues related to pregnancy. We conducted a survey of neurologists and psychiatrists in Dade County, Florida, on various aspects of the care and treatment of women with epilepsy. Dade County was selected because it has a sizable Latino population. A significant proportion of these specialists do not routinely discuss birth control, pregnancy, or the possible teratogenicity of antiepileptic drugs
REFERENCE 1.
Enrique J. Carrazana, M.D. 1 Neurologic Center of South Florida 8940 North Kendall Drive Suite 802-E Miami, Florida 33176 doi:10.1006/ebeh.2000.0084 1 To whom correspondence should be addressed. E-mail: [email protected].
To the Editor:
and the local Epilepsy Foundation affiliate. Our Hispanic population is probably more heterogeneous than Grisolia’s and this may account for some of the differences in our perspectives. We have encountered a strong sense of community and extended family in our Hispanic patients. Indeed, their family structure is often preserved despite severe, often intractable, seizures. Marriages often survive the hardships of this diagnosis, unlike the situation often encountered with other chronic illnesses. We have several male patients with epilepsy who assumed the role of househusbands as their wives support the family. Often, single patients will not only be allowed, but also encouraged to live with their parents or relatives into adult life.
We read with interest the article by Grisolı´a on seizure disorders in Latinos living in Southern California (1). The population in question seems to consist primarily of Mexican immigrants and their treating physicians. Spanish-speaking peoples of various nationalities contend that all Latinos are Hispanics but not all Hispanics are Latinos. Because of their diversity, members of the community in south Florida refer to themselves as Hispanics rather than Latinos. We take care of what is probably the largest population of Hispanics with epilepsy in south Florida through epilepsy clinics at the University of Miami 1525-5050/00 $35.00 Copyright © 2000 by Academic Press All rights of reproduction in any form reserved.
Grisolı´a JS. Epilepsy of the borderlands: seizure disorders in U.S. Latinos. Epilepsy Behav 2000;1;150 –2.
287