Epilepsy and Pregnancy: Is It Safe?

Answers to 4 common patient questions

concerned woman looking at pregnancy test results

For young women newly diagnosed with epilepsy, questions may include those around starting a family: Can I get pregnant? Can I have a healthy pregnancy?

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“Up to 95 percent of women with epilepsy end up with perfectly healthy babies and carry them to term,” says epileptologist Lara Jehi, MD. “The key to doing that is having their seizures well-controlled before they get pregnant and continuing their medications during pregnancy.”

Women with epilepsy often ask Dr. Jehi these 4 questions:

  1. What should I do before getting pregnant?
    Start first by talking to your epileptologist, says Dr. Jehi. She often makes adjustments to the type and dosage of a woman’s medication to provide seizure protection at the minimum required dosage. Her advice: Be seizure-free for six months on a stable dose of medication and take folic acid supplements before becoming pregnant.

  2. Will anti-seizure medications impact my fertility? Anti-seizure medications can affect fertility in both men and women, as can epilepsy itself. About one-third of women have a type of epilepsy that’s closely tied to hormonal changes and can impact fertility.

    But it also works the other way. “Some anti-seizure medications can reduce the effectiveness of birth control pills, so women think they’re protected when they’re not,” says Dr. Jehi. “The key is to discuss both contraception and fertility concerns with both the obstetrician and the epileptologist.”

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  3. Is taking anti-seizure medications during pregnancy harmful to the baby? Many of today’s anti-seizure medications are safe to take during pregnancy, says Dr. Jehi, and stopping treatment during pregnancy can pose significantly more risk to baby and mother should a seizure occur.

    “It can be devastating,” she says. “A generalized tonic-clonic seizure” — what many know as a ‘grand mal’ seizure — “can be very harmful to a baby because the oxygen supply diminishes. That can hurt the baby’s brain development and lead to complications.”

    That’s not to mention the risks posed to mother and child by a seizure-related injury like a fall or an accident.  A woman with epilepsy who is planning to get pregnant should discuss this possibility with her epileptologist, so that her medication regimen can be adjusted and the risk for the baby minimized.

  4. What are the risks that I will pass my epilepsy on to my child? They’re very low, says Dr. Jehi. The risk of developing epilepsy among the general population is about 0.5 to 1 percent, while the risk if you have a parent with epilepsy — whether it’s a mother or father — is 2 to 3 percent.

    “There is a higher risk,” she says, “but not enough of a risk that parents should worry about it. In some purely genetic epilepsies, the risk may be higher, but these are extremely rare situations.”

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