Overview

• Women with epilepsy should take folic acid 5mg daily from before conception to reduce the risk of neural tube defects.

• Pregnancy may worsen seizure control due to the additional stress, lack of sleep, hormonal changes and altered medication regimes.

• Epilepsy should be controlled with a single anti-epileptic drug before becoming pregnant → AIM FOR MONOTHERAPY.

• Women taking phenytoin should be given vitamin K in last month of pregnancy.

• Anti-Epileptic Medications ⇒

  • Safe → levetiracetam, lamotrigine and carbamazepine.
  • Avoid →
    • Sodium Valproate → causes neural tube defects (spina bifida and anencephaly).
    • Phenytoin → causes cleft lip and palate.

• Serial Growth Scans every 4 weeks from 28-36 weeks gestation.

• BREASTFEEDING IS SAFE for mothers taking anti-epileptics.

• RCOG → Exposure to sodium valproate and other AED polytherapy should be minimised by changing the medication prior to conception, as recommended by an epilepsy specialist after a careful evaluation of the potential risks and benefits.

  • SHOULD ONLY BE CHANGED BY SPECIALIST.

Making Diagnosis

Clinical Features

Investigations

Management Plan

Complications →