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Epilepsy and Pregnancy: Keeping Your Baby Healthy

Pregnancy and Childbirth Planning for Pregnancy

Planning for Pregnancy When You Have Epilepsy

Summary & Participants

Epilepsy does not have to stand in the way of a pregnancy. The best way to ensure a safe and healthy baby is to discuss your treatment options with your doctor.

Medically Reviewed On: July 06, 2008

Webcast Transcript

ANNOUNCER: As with any pregnancy, women with epilepsy need to re-evaluate their drug regimen with their neurologist.

CYNTHIA HARDEN, MD: When a woman with epilepsy wants to become pregnant, she should consult with her neurologist about the appropriateness of the medication she's on. Perhaps, in some cases, she could even taper off her medication for pregnancy. If that's not the case, then she and her physician need to make sure that she's on an appropriate medication; in some cases, perhaps consider changing to another medication, and at least streamlining the therapy, so that she's on the least number of medications -- hopefully, only one -- and at the lowest possible dose that still provides good seizure control.

ANNOUNCER: But changing a patient’s anti-seizure medication can be very risky and can potentially lead to an increase in seizure activity. So, changes should only be made to a woman’s drug regimen after careful consultation with her neurologist.

CYNTHIA HARDEN, MD: For a woman to consider coming off medication in anticipation of pregnancy, she needs to have been seizure-free for at least two years on medication and have her EEG normalized. If she's had a very mild seizure disorder that has come under good control readily with anti-seizure medicines and she stayed very well-controlled, this may be a situation in which she could safely taper off her medication.

ANNOUNCER: In general, most women need to stay on their medication through pregnancy.

CYNTHIA HARDEN, MD: In general, the risk of seizures is thought to be greater than the relative low risk of birth defects associated with these medications, particularly when they are used as a single agent, used alone and at the lowest possible dose. So, many times the decision is to stay on their medication during pregnancy, because it's thought to be safer overall.

ANNOUNCER: Outside of taking steps to reduce anti-seizure medications, there are other steps a woman with epilepsy can do to ensure a healthy pregnancy.

CYNTHIA HARDEN, MD: They should make sure they have had adequate nutrition and this includes taking multiple vitamin as well as folic acid at the usual dose of about 1 milligram per day before conception.

ANNOUNCER: The bottom line is, if a woman with epilepsy is able to adequately control her seizures prior to conception, she can usually look forward to a safe and healthy pregnancy. And planning the pregnancy with her neurologist’s help is key to ensuring that.

CYNTHIA HARDEN, MD: When a woman with epilepsy becomes pregnant, her chance of having a healthy baby is very high. It's well over 90 percent, probably 94 or 95 percent.

TRACY GLAUSER, MD: A woman who has epilepsy needs to communicate clearly and frequently with their health care provider when she intends to become pregnant. Planning a pregnancy is the best way to try and avoid any complications from either the epilepsy or its therapy.

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