Managing epilepsy in pregnancy

Abstract

Epilepsy is one of the most common neurological disorders. Although there may be associated fertility issues and many women with epilepsy may choose not to conceive, it is estimated that at least two to five out of every thousand pregnancies in the UK occur in women with active epilepsy. The overwhelming majority of such cases will have an uneventful pregnancy and will deliver a healthy baby. However, there are issues surrounding epilepsy in pregnancy. These issues are multiple, but include the potential teratogenicity of the antiepileptic drugs, in terms of both major structural defects and of neurodevelopmental delay and loss of seizure control, perhaps due to enhanced clearance of the drugs. In addition, obstetric complications may be encountered more frequently, and maternal death, usually linked with loss of seizure control, is also over-represented in this group. This article details what is known about the prevalence of epilepsy in pregnancy and how epilepsy may impact on pregnancy outcome. © 2011 Expert Reviews Ltd.