Treating epilepsy in pregnancy

121009727Epilepsy and pregnancy. Not an impossible combination, but certainly a difficult one. It’s also rare – according to research from 1999 only 0.5% of all pregnancies occur in epileptic women – but it is this very scarcity of cases that causes epilepsy in pregnant women to be under-researched.

As it stands, the advice for mothers-to-be suffering from epilepsy is mixed. And mixed messages cause confusion.

On one side, some research suggests that in 95% of cases of pregnancy in epileptic women, both mother and child do well, as long as there’s careful management of the condition before, during, and after pregnancy. This need for careful planning and management is underlined in other research, since a pregnancy’s outcome depends on good support from physicians. Indeed, a study in Norway specifically looked into antiepileptic drug use during pregnancy, and called for “special attention” to women taking such medication. The positive message here? That epilepsy and pregnancy don’t have to be mutually exclusive.

But not everyone’s convinced by these arguments. If the “good news” is limited to academic journals and publications, the “bad news” about epilepsy and pregnancy is quick to reach mainstream media. This article, published earlier this year, cites research in Norway and Denmark which asserts that children born to epileptic mothers are more likely to develop at a slower rate than average, and to show symptoms of autism. While observers suggest that this could be due to selection bias (where the mothers entering the study are already concerned about how their antiepileptic drugs affect their fetus and are looking out for delays in development), the message remains: we just don’t know enough about how these drugs affect the fetus.

As for any condition that affects women of childbearing age, there’s a strong case for more research and better information; for fewer myths and for more facts. That’s why initiatives like this one, for women suffering from epilepsy in the UK, are so valuable.

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