Pregnancy and epilepsy: What should we tell our patients?

Torbjörn Tomson, Dina Battino

Research output: Contribution to journalArticle

Abstract

Women with epilepsy that plan to become pregnant can in general look forward to uneventful pregnancies and to giving birth to normal children. However, there are certain risks associated with epilepsy and antiepileptic drug (AED) treatment, and it is likely that these risks can be reduced with appropriate prepregnancy counseling. Women with epilepsy should be informed that maintained control of tonic-clonic seizures is important for their health as well as for the well-being of the fetus; that pregnancy in general has little effect on seizure control; but that pregnancy may affect plasma concentrations of AEDs, and that drug level monitoring and dosage adjustments may be needed. They should be informed of the moderately increased risk of birth defects, and that this risk appears to be higher with the use of valproate, in particular at doses above 800 mg/day. The possibility of changing from valproate to another AED should be considered, but such changes should be tried out before conception. Withdrawing or changing an AED should generally be avoided during pregnancy. Women with epilepsy on AED treatment should be encouraged to breast-feed.

Original languageEnglish
Pages (from-to)856-862
Number of pages7
JournalJournal of Neurology
Volume256
Issue number6
DOIs
Publication statusPublished - Jun 2009

Keywords

  • Antiepileptic drugs
  • Epilepsy
  • Pregnancy
  • Teratogenic effects

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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