Epilepsy in pregnancy

Epilepsy is a relatively common condition among young people. However, large strides have been made in controlling epileptic seizures using medication. This has meant that the majority of epileptics lead virtually independent lives with little risk of convulsions.

Pregnancy presents a unique challenge in the life of a woman with epilepsy. This is not only because of anxiety about what effect pregnancy might have on the condition (which is unpredictable), but also because of such factors as the effect of the pregnancy on the dose of medication.

There is also the fear of convulsions and its potential consequences on the pregnancy, the effect of the anticonvulsant medication on the fetus and many more.

All these questions and many others have been tackled in this section. Not all the answers are known and it will be pretentious for any physician to suggest otherwise. However, as in most chronic conditions that individuals learn to live with, the optimal results, both in terms of a problem-free pregnancy and a good outcome, lie in the meticulous control of the condition.

The buck, as the old adage goes, ultimately stops with the individual. The decision to take medication as recommended always lies with the patient.

It needs to be stated early that all anticonvulsant (anti-epileptic) medications taken by the mother have the potential to cause harm to the baby. However, the type and degree of harm varies.

The potential for adverse effect on the baby does, however, differ from one group of anticonvulsants (anti-epileptics) to another. Such consequences are uncommon, even in collective terms.

Moreover, options for changing from one anticonvulsant to another that may be deemed relatively safer are sometimes quite limited in real life. This is because there may be justifiable anxiety about abandoning a drug with proven effectiveness for another, which may not be as good in that particular individual. Moreover, a switch needs to be made before conception, to be effective in skirting the potential adverse effects on the fetus.

Many pregnancies among women with epilepsy are "discovered" at a five to six week stage, too late for any such measure. All these subjects are dealt with in detail in this section.

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There is no such thing as an absolutely safe anticonvulsant in pregnancy. However, the level of risk varies