Epilepsy and Pregnancy

Epilepsy (convulsions) is a lifelong (chronic) disease that causes recurrent convulsions. These episodes are unpredictable. The convulsions happen because of a brain dysfunction when the nerve cells produce too many electrical discharges. These discharges make the body shake. There are no clues to tell whether a patient's epilepsy will be aggravated during pregnancy. Only about one quarter of pregnancies which have been seizure (convulsions) free for the 9 months before pregnancy will have seizures during pregnancy. Most women with epilepsy will have a normal, healthy baby.

RISKS TO BABY:

  • Partial or complete separation of placenta from uterus (partial/complete uteroplacental separation).

  • Late-term fetal death (stillborn)

  • Birth defects. This may be due to the medications used to treat epilepsy.

WOMEN WITH EPILEPSY HAVE A HIGHER INCIDENCE OF:

  • Uncontrolled and continuous nausea and vomiting (hyperemesis gravidarum).

  • Vaginal bleeding.

  • Anemia.

  • Endocrine hormone disorders.

  • Premature labor.

  • Failure to progress in labor.

  • Increased rate of Cesarean Sections.

  • Menstrual problems.

  • Polycystic ovary syndrome.

CAUSES

  • Some people are born with the problem.

  • Head trauma.

  • High fever over 104° F (40° C).

  • Brain tumors.

  • Infection of the brain.

  • Diabetic patients that took too much insulin and have too low of a blood sugar.

SYMPTOMS

  • There may be no convulsions with only a short lapse in consciousness of thought or activity with fast fluttering of the eyelids.

  • Shaking and stiffness all over the body.

  • Shaking only in specific areas of the body.

  • Convulsions that occur when asleep (nocturnal epilepsy).

DIAGNOSIS

The diagnosis is usually made by observing the convulsion. Other means of diagnosis are:

  • EEG (electroencphalogram) analyzing brain waves with electrodes.

  • CT scan of the brain.

  • MRI of the brain.

  • Blood tests that may help in treating the problem.

TREATMENT

Anti-epileptic drugs (AEDs) are used to treat epilepsy. AEDs can have side effects on the baby.

HOME CARE INSTRUCTIONS

  • Follow your caregiver's advice and treatment if you are planning to get pregnant or are already pregnant.

  • Have a neurologist follow your pregnancy.

  • Keep all your prenatal neurologist appointments.

  • If you are planning to get pregnant, take supplemental vitamins and folic acid (0.4 mg a day) before and during your pregnancy.

Your caregiver will answer questions about your treatment and care of your seizure disorder if you are planning a pregnancy or already are pregnant. If planning a pregnancy, obtain counseling and keep up your regular prenatal appointments as directed.

SEEK MEDICAL CARE IF:

  • You have a seizure and never had one before.

  • You think you are having minor or isolated seizures.

  • You do not feel the baby moving or the baby is not moving as it usually does.

  • You develop abdominal pain.

  • You develop vaginal bleeding with or without abdominal pain.

  • You develop severe headaches.

  • You develop vision problems or numbness on your body.

  • You develop uncontrolled vomiting.

  • You develop tiredness, weakness or faint.

Pregnant women with epilepsy and taking AEDs may register with the North American AED Pregnancy Registry. This is located at Massachusetts General Hospital, Harvard Medical School. Phone toll free: 888-233-2334.