Pregnancy and Epilepsy: Monitoring and Treating the Seizures

Objectives: Epilepsy is the second most common neurological disorder after migraine in pregnancy. The most suitable antiepileptic drug (AED) to be chosen in this period would minimize the possible maternal and fetal complications. The present study monitors the pregnancies and prognoses of pregnant patients with epilepsy, who were treated in our clinic, and evaluates the efficiency of the antiepileptic treatment. Methods: In this study, 50 pregnant patients were included who were examined and treated in the epilepsy clinic from January 2000 to May 2018. Seizure types and frequencies, AEDs used, and pregnancy processes of the patients were investigated retrospectively based on their medical file records. Results: Of the 1965 patients with epilepsy, the number of pregnant patients included in this study was 50 (2.54%), while the total number of pregnancies was 68 and 27 pregnant patients had generalized onset seizures. There were not any changes in the seizure frequency in 57.1% of the patients. In this study, 40 patients were treated with monotherapy. The most frequently preferred AED was valproic acid with 10 patients. During the pregnancy, the daily dose was increased for 10 patients, and the drug with the highest increment was lamotrigine with four patients. Considering the births concerning fetal malformation, only one infant had spina bifida, and there were no stillbirths. Conclusion: This hospital-based study showed that the course of seizure frequency during pregnancy is unpredictable. Following-up and monitoring the pregnant patients closely are of critical importance for pregnant women with epilepsy to have a healthier pregnancy with possible lowest complication rates.