Epilepsy in Pregnancy

Question 1

What are the main causes of seizures in pregnancy?

Answer 1

1. Epilepsy
2. Eclampsia
3. Cerebral vein thrombosis
4. Space-occupying lesion
5. Stroke
6. Hypoglycaemia, hyponatraemia
7. Drugs, alcohol, withdrawal
8. Infection

Question 2

What medication should be stopped pre-conception and what should it be changed to?

Answer 2

Stop valproate and switch to lamotrigine/carbamazepine.

Question 3

What do anti-epileptic drugs increase the risk of and what should be taken alongside then?

Answer 3

1. Neural tube defects

2. Folic acid 5mg daily to term

Question 4

What supplement should be given if on a hepatic enzyme inducing anti-epileptic drugs, and what does this prevent?

Answer 4

1. Vitamin K 10mg PO daily

2. Haemorrhagic disease of the new born

Question 5

What is the protocol for postnatal care of mothers prone to seizures?

Answer 5

1. Keep in for 24 hours
2. Encourage breastfeeding
3. Change anti-epileptic drug dose back to pre-pregnancy levels
4. Discuss methods to avoid dropping baby during seizures.