Women and Epilepsy
Why do I have seizures only around the time of my period?
Some women have seizures related do their monthly cycle. This is called catamenial epilepsy, which appears related to estrogen and progesterone fluctuations during the menstrual cycle.
Estrogen has proconvulsant effects and progesterone anticonvulsant effects; changes in the concentrations of these hormones may affect seizure control.
If you have catamenial epilepsy, your doctor may want to prescribe acetazolamide, hormonal therapy, or other treatment in addition to your antiepileptic drugs.
Will taking birth control pills cause me to have more seizures?
In general, oral contraceptive do not affect the blood levels of antiepileptic drugs and should not affect seizure control.
Will antiepileptic drugs affect the efficacy of the birth control pill?
Because oral contraceptives and many antiepileptic drugs are metabolized by the liver, there is the possibility that one may affect the metabolism of the other
What is the best medication for treating seizures in pregnancy?
Although you may hear differently, it is now generally agreed that the best choice of epilepsy medication in pregnancy is the drug that eliminates the most seizures with the fewest side effects.
You and your neurologist must choose the antiepileptic drug that is best for you.
How will pregnancy affect my seizure frequency?
Seizure frequency may increase during pregnancy. Part of the reason for this increase is that many women stop their epilepsy medications. This is usually not the best thing to do.
Seizures may also occur because pregnancy can cause poor absorption of medication and an increase in anti-epileptic drug metabolism, both of which result in lower drug levels.
In order to have the best control of seizures during pregnancy, it is essential to visit both your obstetrician and neurologist regularly.
Should I discontinue my epilepsy medications if I become pregnant?
Although anti-epileptic medications may cause birth defects, they usually do not. The risk of birth defects in children to women with epilepsy is about 6%. That means there is a 94% chance there will be no birth defects.
The most serious birth defects occur early in pregnancy, before you even know you’re pregnant. That is why stopping your anti-epileptic medication will probably increase your seizures and not help your baby very much.
However, regardless of which anti-epileptic drug you are taking you should not discontinue it until you have consulted your neurologist.
The risk of harm to you and your baby from uncontrolled seizures may be higher than the risk to your baby from anti-epileptic medication.
Is there a way to check for birth defects?
Yes, One blood test is called alpha-fetoprotein, which you should get at approximately 18 weeks, it is also important to get an ultrasound at this time.
What can I do to make sure I have a healthy baby?
Plan your pregnancy! That way you can begin taking prenatal vitamins and folic acid, make sure you get nutritious foods, get enough sleep, and avoid alcohol, drugs, and cigarettes.
Can seizures occur during delivery?
Yes, but only 1 to 2% of women with epilepsy have a convulsion during labor and delivery. This is a time of high stress, anti-epileptic medications may have been missed, and sleep deprivation is likely.
But seizures can be easily treated in the delivery room with intravenous medication.
Can I breast-feed?
Epilepsy medication appears in the breast milk to some degree but usually does not affect the infant.