How to Manage Epilepsy during Pregnancy?


It is known that exposure to anti-epileptic drugs (AED) can result in possible congenital malformations, new data indicates that managing epilepsy and differentiating the high-risk drugs can improve fetal outcomes and achieve disease control. Even some combination of multi-drug anti-epileptic treatment has not resulted in poor outcomes.  

During pregnancy intrauterine fetal growth, obstetric complications, and neonatal complications should be closely monitored. Breastfeeding does provide neurodevelopmental benefits and should be an option for women on AEDs.



1.5 million women with epilepsy are of childbearing age 

Women on AEDs: 22 per 1000 births in the US  ( as of 2009) 

Anti-epileptic Drugs:

According to the North American Pregnancy registry, the medication that was associated with the lowest rate of malformation was Lamotrigine as mon-therapy. 

Carbamazepine and Lamotrigine combination in pregnancy was also associated with the least risk of malformation.

Valproic acid was associated with the highest risk of fetal malformation as a single drug treatment.

Valproic acid and Lamotrigine combination treatment was associated with a high risk of fetal malformation

While the above is general guidance and common practice guidelines, the best treatment regimen is determined by your neurologist.  Please talk to your neurologist as to what regimen is best for you and your type of epilepsy. 

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