Pregnancy and epilepsy
Question : I have a question that could affect my brotherís future. He is about to marry a great gal (30 years old). They are great together
and so excited about getting married and starting a family. We thought it was a little strange that she never drove a car, and then learned the reason
why: She has had epilepsy all her life. She says she hasnít had a seizure in years because doctors finally got her medication right. She just got used
to not driving and didnít want the expense. Now Iím worried that maybe they shouldnít have
children. Can women with epilepsy become pregnant, and is it safe?
Answer : Yes, women with epilepsy can and do become pregnant. The vast majority of them ó more than 90 percent ó do so successfully if the
following conditions are met:
1) They work with an experienced physician specializing in
epilepsy to select one antiepileptic drug (not multiple drugs) to manage seizures.
2) They take supplemental folic acid.
3) They refrain from using alcohol and tobacco.
4) They seek high-risk obstetrical care.
As a rule, a woman should continue antiepilepsy medications during pregnancy.
Ideally, women should work closely with their physicians before conception to determine the best medicines for controlling seizures while causing minimal
side effects for the developing fetus and the breast-fed infant. Her physician also needs to be alert for potential interactions between antiepileptic
drugs and a womanís changing hormones during pregnancy.
Many women with epilepsy choose not to take their medications during pregnancy due to concern about birth defects. We try to discourage this by
educating patients about the benefits of continuing medications. There is a slightly higher incidence of birth defects in women who take drugs to control
seizures: 4-6 percent vs. 2-3 percent among the general population.