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August 2017; 7 (4) Commentary

Practice Current: How do you treat epilepsy in pregnancy?

Ilena C. George
First published August 1, 2017, DOI: https://doi.org/10.1212/CPJ.0000000000000387
Ilena C. George
From Yale University Department of Neurology, New Haven, CT.
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Practice Current: How do you treat epilepsy in pregnancy?
Ilena C. George
Neurol Clin Pract Aug 2017, 7 (4) 363-371; DOI: 10.1212/CPJ.0000000000000387

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Epilepsy affects millions worldwide and women of childbearing age constitute between 25% and 40% of all patients with epilepsy.1,2 Estimates based on the population in the United States in the 1990s approximate that 25,000 children are born to women with epilepsy (WWE) annually.3,4 For WWE who are pregnant or planning to become pregnant, providers should consider the potential risks regarding seizure control, obstetric complications, and teratogenicity of antiepileptic drugs (AEDs) when counseling patients and determining a treatment plan.5,6 Studying pregnant women poses unique challenges. Randomized control trials are difficult to conduct in this population, and much of the available data is observational by necessity, which precludes many studies from reaching the most rigorous levels of evidence. Several aspects of the care of pregnant WWE are discussed in this commentary, with a special focus on teratogenicity and drug monitoring.

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  • Practice current: An interactive exchange on controversial topics Luca Bartolini, MD, Section Editor

  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • © 2017 American Academy of Neurology
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The Nerve!: Rapid online correspondence

  • LETTER RE: How do you treat epilepsy in pregnancy?
    • Khichar Purnaram Shubhakaran, MB, BS, MD(Med), DM Neurology, Physician, Dr. S. N. Medical College
    Submitted August 25, 2017
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