Epilepsy in women: the special care

Epilepsy of women of childbearing age is characterized by features of care related to any contraception and preparation of monitoring a potential pregnancy. A topic discussed in the International Epilepsy Congress.

A normal life is possible

Forming a family and having children are fundamental aspects of our lives. But at the beginning of this century, it is still unknown that the vast majority of women with epilepsy can lead a normal life and a comprehensive care avoids many risks.

Pregnancy is possible but requires preventive measures such as the adaptation of treatment before conception and clinical monitoring involving neurologists and obstetricians.

During the congress were also presented the results of pregnancy registries in epilepsy treatment, from international studies. Indeed, the complexity of epilepsy and the legitimate needs of patients having a child makes keeping prospective records essential pregnancies. This is the only way to better learn how to identify the risk of each of the available drugs and to assess the risks and benefits.

Thus, even if the majority of uncomplicated pregnancies occurs in epileptic patients, it is still high-risk pregnancies that require the implementation of preventive measures.

The main preventive measures

These can be summarized in four main points:

- Adaptation of antiepileptic treatment before conception by the maximum for a single drug, the lowest possible dose;

- Joint Clinical monitoring between the neurologist and gynecologist during pregnancy due to the risk of change in the frequency of seizures and of possible adverse effects on pregnancy outcome of certain drugs. Many factors may contribute to the frequency of crises throughout the expectation of a baby: hormonal, metabolic, sleep disturbances, poor compliance;

- Ensure adherence to treatment, taking care to explain to the patient that the full stop and brutal treatment may have even greater consequences (occurrence of fetal injury in an accident due to a crisis, for example);

- After delivery, good seizure control with regular medical follow-up and possible home help prevent the risk of accidents with the baby (such as a fall during hygiene care or port infant) . However, the act of taking an antiepileptic drug is not a cons-indication to breastfeeding.

As for contraception, although some AEDs can reduce the effectiveness of the pills with the key, the risk of unwanted pregnancy, most new generation molecules reduces or even eliminates this risk.