Epilepsy and Pregnancy
Women with epilepsy can bring healthy babies into the world just as women with other disorders. There are still many myths surrounding epilepsy and women who have not consulted a health care professional may have heard and believe some of the myths surrounding epilepsy and pregnancy.
Nearly 2.5 million Americans suffer from epileptic seizures. Severity ranges from one mild seizure in a lifetime to reports of 60 seizures a day. There are several different medications to control seizures while people with the most severe cases still opt for surgery to split the right and left hemispheres of the brain. Women who want to become pregnant have many concerns to address.
One of the biggest concerns of pregnant women who have epilepsy is the medication taken to control the seizures may cause birth defects such as Downs Syndrome. Another concern is pregnancy may increase the number of seizures. The best thing a woman with epilepsy can do is to consult a preconception counselor before becoming pregnant.
Preconception Counseling
A specialist in preconception counseling will take a complete family history, medical history and a series of tests to determine if you are healthy enough to become pregnant. If there are concerns about the medication you are taking the preconception counselor will advise you a change is needed. Preconception counseling will take time so plan ahead to begin any changes to your treatment. You will need at least 6 months to a year before planning to have a child.
It can take an epileptic woman up to 6 months to conceive. The rate of conception for an epileptic woman is 25% to 33% less than average; a reason why women with epilepsy have fewer children.
Pregnancy
You will be closely monitored from conception to birth. Your obstetrician will be working closely with the doctor treating your epilepsy to keep mother and child in optimum health. Any seizure you may have during pregnancy must be reported immediately no matter how mild it may seem.
It is important that you follow the diet suggested, continue mild exercise and get plenty of rest. Your antiepileptic medication should also be taken as directed with no missed or skipped dosages. Hormonal changes can affect the number and frequency of seizures you have though some women report fewer seizures during pregnancy.
Topamax and pregnancy
The FDA has recently issued a warning that Topamax (topiramate) is a high risk antiepileptic drug that can cause the birth defects cleft lip and cleft palate if taken in the first trimester of the pregnancy. The drug is also used to control migraines. Topiramate prevents the mouth from becoming fully develop leaving a split lip or a deep groove or hole in the roof of the mouth. Oral clefts are rare in the US. Surgery is performed to repair the lip and/or mouth and is usually successful.
Johnson and Johnson, the pharmaceutical company that makes Topamax, is working to put a stronger warning label on the medication. If you have taken Topamax while pregnant notify your doctor immediately. Do not stop taking Topamax without directions from your doctor.
Many women with epilepsy have safely delivered healthy children. Appropriate monitoring before and during pregnancy makes it possible for women with epilepsy to have children.
