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Does pregnancy per se make epilepsy worse?
F J E Vajda1, T J O'Brien1, C M Lander2
1Departments of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Parkville, Vic., Australia.
Acta Neurologica Scandinavica
|September 9, 2015
Summary
Pregnancy itself appears to worsen epilepsy seizure control, even without medication changes. This study found more seizures during pregnancy compared to before, suggesting pregnancy per se impacts epilepsy management.
Area of Science:
- Neurology
- Obstetrics
- Pharmacology
Background:
- Epilepsy affects women of reproductive age.
- The impact of pregnancy on seizure control is complex and multifactorial.
- Understanding pregnancy's independent effect on seizure control is crucial for managing epilepsy during gestation.
Purpose of the Study:
- To investigate whether pregnancy, independent of antiepileptic drug (AED) use, affects epileptic seizure control.
- To quantify changes in seizure frequency during pregnancy compared to pre-pregnancy periods.
Main Methods:
- A study cohort of 148 pregnancies was analyzed.
- Women with no AEDs before pregnancy and in at least the first half of pregnancy were included.
- Seizure occurrence during pregnancy was compared to the pre-pregnancy year, controlling for confounding factors like AED withdrawal or resumption.
Main Results:
- A significantly higher percentage of women experienced seizures of any type during pregnancy (56.6%) compared to before pregnancy (35.5%).
- Convulsive seizures also increased significantly during pregnancy (39.4%) versus pre-pregnancy (18.2%).
- A trend, though not statistically significant, indicated a greater loss of seizure control in genetic generalized epilepsies compared to focal epilepsies during pregnancy.
Conclusions:
- Pregnancy per se appears to negatively impact epileptic seizure control.
- This effect is observed irrespective of changes in antiepileptic drug disposition.
- The findings highlight pregnancy as a potential independent risk factor for worsening seizure control in women with epilepsy.
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