Pregnancy and epilepsy

In a prospective study, 30 pregnant epileptic patients were followed through their pregnancy to determine the effect of seizures on pregnancy and its outcome and the effect of pregnancy on seizures. An attempt was made to correlate the serum hormone and anticonvulsant drug levels with seizure frequency, complications of pregnancy, occurrence of status epilepticus and teratogenicity. In 14 patients seizure frequency increased, in 15 it remained unchanged and in 1 patient it decreased. There were 2 spontaneous abortions, 2 patients had status epilepticus and 1 offspring of a patient had a ventricular septal defect. This patient was receiving carbamazepine and diphenylhydantoin. Patients with increased seizures frequency had significantly higher oestrogen levels, lower level of progesterone and lower level of anticonvulsant drugs as compared with those with no change in seizures. Patients who had abortions and those who developed status epilepticus had high serum oestrogen levels.