Epilepsy and Pregnancy: Everything you need to know

January 26, 2024

minutes

Epilepsy and Pregnancy: Everything you need to know

Can you be pregnant with epilepsy?

‍

Many people with epilepsy have concerns about what pregnancy planning looks like. Many medications may not be safe or need to be changed, and the dosages of some medications may need to be adjusted during pregnancy. Being pregnant when you have epilepsy doesn’t have to be scary, and we will try to demystify this for you.

‍

Talk With Your Doctor About Pregnancy and Epilepsy

The single most important thing to do if you have epilepsy and would like to consider pregnancy planning is to discuss this well in advance with your epilepsy specialist. This includes discussing what your current use of contraception is, and when you plan to stop contraception and start pregnancy planning. Folic acid is an important supplement to take prior to pregnancy, and it is particularly important if you are taking some of the antiepileptic medications that lower your folic acid level. Also, always let your obstetrician know the medications you are on, and the adjustment plan moving forward.

‍

Epilepsy Medications and Pregnancy

Once you have an approximate date to start pregnancy planning, your doctor may recommend switching the anti-seizure medication to a safer option for pregnancy. It’s important to note that some forms of contraception may also be contraindicated with some anti-epileptic medications, and in some circumstances your contraceptives may have to be adjusted as well. Once you are on the appropriate medication for pregnancy, your specialist will ask you to obtain a blood tests to make sure that the level of the medication in your blood is therapeutic.

‍

We don’t want to risk the possibility of you having a seizure during pregnancy. We always try to limit the risk of seizure, but during pregnancy you are considered more high risk. The blood levels of your anti-seizure medications will be checked monthly and we may need to make adjustments based on these results. When you are pregnant you metabolize medications differently, and the blood volume in your body increases. These factors sometimes lower the level of the medication in your blood, even if you have previously been on a stable dose of the medication for many years.

‍

Delivery with Epilepsy

Most pregnancies, even with epilepsy are able to be delivered vaginally, however there may need to be discussion with your obstetrician and epilepsy specialist about some of the details of delivery. When you are in the hospital the levels of your medications will be monitored closely again, and further adjustments may be necessary. If you are considering breastfeeding, there are generally fewer concerns about medication safety, however we do encourage you to closely follow up again with your epilepsy specialist 1-2 weeks after delivery.

‍

At Neura Health we are here for you during this joyous (and scary!) time, and we will do our best to lead you through this process.

‍

For more great content, follow us:

Indranil Sen-Gupta, MD

Indranil Sen-Gupta, MD is a board-certified neurologist specializing in epilepsy.

About the Author

Dr. Sen-Gupta grew up in Fremont, California and developed an early interest in computers and technology being raised in the Silicon Valley. He hoped to one day apply these interests directly to the care of patients. After completing his undergraduate degree in Electrical Engineering at Northwestern University, Dr. Sen-Gupta remained at Northwestern for his medical training, earning his MD degree from the Feinberg School of Medicine. His Neurology rotations in medical school guided his path to pursuing Adult Neurology residency training at Northwestern, during which he realized that subspecialty Fellowship training in Epilepsy and Clinical Neurophysiology would integrate and directly apply his engineering background to patient care. After completing subsequent Fellowship training in Clinical Neurophysiology (with Epilepsy emphasis) at the University of California, Los Angeles, Dr. Sen-Gupta joined the Neurology faculty at the University of California, Irvine as a staff Epileptologist. During his almost 9 years on Neurology faculty, Dr. Sen-Gupta oversaw the care of multiple patients with epilepsy (including management and evaluations of patients with complex medically intractable seizures), and provided physician oversight for intraoperative neuromonitoring services. Dr. Sen-Gupta is presently a full-time intraoperative physician reader for Neuromonitoring Associates, and is excited to develop Neura Health’s outreach to the care of the patients with epilepsy.