Epilepsy in pregnancy

1. EPILEPSY
Prenatal advice
 History taking, proper exploration of her seizures.
 Advise to take folic acid 5mg daily prior to
conception, continue throughout pregnancy.
 Information about risk of epilepsy, anti- epileptic
drugs and their side effect, teratogenic risks.
 No need to change AED in pregnancy if epilepsy is
well controlled with phenytoin, carbamazepine,
valproate, lamotrigine or phenobarbitone.
 Withdrawal is inappropriate (those who have not
been seizure-free for two years, those whose specific
epilepsy syndrome is known to require continual drug
treatment and those unwilling to accept a risk of
seizure recurrence)
 Consideration should be given to converting multiple
drug regime to single drug regime.
 Lowest effective dose that protects against seizures.
 Offer nuchal translucency scanning and detailed
ultrasound at 18-20 week once she got pregnant.
ADMINISTRATION OF DRUGS
 Patients on hepatic enzyme inducing drugs should be
given Vitamin K 10 mg orally
 Neonate should receive 1 mg Vitamin K IM soon after
birth
DELIVERY AND POST NATAL CARE
- There is an increased risk of seizures around the time
of delivery and the following 24 hours
- Breast-feeding is safe and should be encouraged
- Mother should avoid excessive tiredness, changing
the baby on the floor to prevent fall, and bathing the
baby with another adult present in case of seizure.