Epilepsy in pregnancy

doi:10.1136/bmj.39266.473113.BE

BMJ 2007;335:769-773 (13 October), doi:10.1136/bmj.39266.473113.BE

Practice

Pregnancy plus

Epilepsy in pregnancy

Torbjörn Tomson, professor¹, Vilho Hiilesmaa, professor²

¹ Department of Clinical Neuroscience, Karolinska Institutet, SE-171 76 Stockholm, Sweden, ² Department of Obstetrics and Gynaecology, Helsinki University, PL140, 00029 HYKS, Finland

Correspondence to: T Tomson torbjorn.tomson@karolinska.se

This article explores the therapeutic problems that arise whena patient with epilepsy on treatment becomes pregnant and needsboth effective seizure control and attention to the safety ofher fetus

The first 150 words of the full text of this article appear below.

Introduction

Scenario

A 33 year old woman had had occasional myoclonic jerks in themornings since the age of 15, usually after sleep deprivation.Two years later, after her first generalised tonic-clonic seizure,she was diagnosed with juvenile myoclonic epilepsy, an idiopathicgeneralised epilepsy. After her second tonic-clonic seizureshe was prescribed valproate. During the next two years, shehad a few more tonic-clonic seizures until the dosage of valproatewas increased to 500 mg twice daily. On this medication, shewas free from seizures for 11 years and only had isolated myoclonicjerks—years apart—always after sleep deprivation.

Twoyears ago, her medication was changed from valproate to lamotriginein response to her plans for pregnancy and the concern thatvalproate could be teratogenic. This conversion was uneventful.She has remained free from tonic-clonic seizures, but her myoclonicjerks have been slightly more frequent despite a lamotriginedose of 150 mg twice . . . [Full text of this article]

How common is epilepsy in pregnancy?

Does pregnancy affect epilepsy?

How do seizures affect pregnancy?

What are the risks to the fetus from antiepileptic drugs?

How do I monitor treatment and alter drug doses?

Preconception planning

Obstetric management and breastfeeding

Conclusions

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

Relevant Article

Teratogenicity of antiepileptic drugs: David P Breen and Richard J Davenport
BMJ 2006 333: 615-616. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

Ackers, R, Besag, F M C, Wade, A, Murray, M L, Wong, I C K (2009). Changing trends in antiepileptic drug prescribing in girls of child-bearing potential. Arch. Dis. Child. 94: 443-447 [Abstract] [Full text]