Neurológia pre prax 5/2010

Epilepsy, pregnancy and breastfeeding

The question whether a woman with epilepsy can become pregnant and give birth to a healthy child is still one of the most important for women in the childbearing age with this chronic neurological disease. The majority of women with epilepsy can have an uncomplicated pregnancy and give birth to a healthy child (Tomson, Battino 2009). There are risks related to the disease itself and/or to treatment with antiepileptic drugs (AEDs). These risks can be minimized by appropriate individual approach and counselling. For a woman with epilepsy and the developing fetus, it is particularly important during pregnancy to control generalized convulsive seizures, monitor the levels of AEDs and individually adjust the doses of AEDs administered. Some published data clarify how to optimally care for women in the childbearing age when planning a pregnancy as well as during the pregnancy, puerperium and lactation. Gathering information in national and international registries as well as reviews of publications leads to guidelines and evidence-based conclusions. There still remain a number of questions to which there are no unequivocal, scientifically-proven answers. Given the diversity of individual epileptic syndromes and the variety of AEDs administered, the situation of each woman with epilepsy needs to be assessed with respect to these facts.

Keywords: epilepsy, pregnancy, breastfeeding.