Epilepsy During Pregnancy – Causes, Symptoms & Treatments

Do you suffer from epilepsy? Are you worried how pregnancy may affect your seizures or the effectiveness of your medications? Fret not. Here we talk about epilepsy, and what you can do to ensure that it does not cause any issues during pregnancy.

What Is Epilepsy?

Epilepsy is a condition that first occurs during childhood, even though it is possible that it can start at any age. One of the most common symptoms of epilepsy is repeated seizures.

When your brain experiences an abnormal pattern of electrical activity, it can result in seizures. When you experience a seizure, your body often starts to move involuntarily and is out of your control. In severe cases, epilepsy can also lead to fainting spells and temporary loss of consciousness.

Does Epilepsy Become More Frequent Or Severe During Pregnancy?

There is not many medical data that can support any sure information about the relation between your pregnancy and the epileptic condition. In some cases, your epilepsy may remain unaffected when you get pregnant, while, in some other, it may also result in a decrease in the symptoms of epilepsy.

In many cases, the seizures that are related to epilepsy can get worse when you are pregnant. During your pregnancy, you experience a lot of physical as well as emotional stress. All of this can worsen your epilepsy symptoms and result in seizures that can become more severe as well as frequent [1].

Can Epilepsy Affect Your Pregnancy?

If you know that you suffer from epilepsy and want to get pregnant, you should first get in touch with your medical practitioner and understand the risks that may be associated with the same. Your doctor will be able to assess your condition and recommend a change in medication that you are already taking so that it does not have an effect on your pregnancy.

If you are already pregnant and are also epileptic, it is important to know that suffering seizures during these months can hurt you and your baby’s health. Here are a few ways your epileptic seizures can have a negative effect on your pregnancy:

• The epileptic seizures can cause a deceleration in your unborn baby’s heart rate

• A seizure can also cause injury to your unborn baby

• It can sometimes be strong enough to make your placenta move away from the uterus before it is supposed to, resulting in a premature separation known as placental abruption

• An epileptic seizure during pregnancy can also lead to miscarriage because of the trauma it can exert both on you and your unborn baby

• Seizures during your pregnancy can lead to a premature labor that will lead to premature birth

• Experiencing an epileptic seizure during pregnancy can also result in a still birth.

• In case the baby is born normal even if you have epilepsy during your pregnancy, there are chances that the baby will also develop seizure disorders in later years

• If you are epileptic during your pregnancy, it can cause various developmental and growth delays in your baby

• In some cases, the baby may experience bleeding issues right after birth

• If you stop taking your epilepsy or anti-seizure medication during your pregnancy, it can pose a higher risk to your baby than if you do take those medications. Some such health risks that your baby could be affected with are delays in development, physical injury as well as fetal death.

When Should You Call Your Doctor?

When you know that you are at risk of epilepsy or have suffered from the same in your past, it is important to keep your doctor informed of the same. Also, you should always have a standby emergency number where you can reach your doctor, especially if you suffer an epilepsy attack while you are pregnant. Watch out for these following signs and keep your partner or family informed, that as soon as any of the following happens, you should speak to a doctor or rush to the nearest medical facility immediately:

• If you experience a seizure that goes on for more than five minutes

• If your seizure has stopped, but you are not able to breathe or are still unconscious (this is why your partner or immediate family should be aware that they need to get you to a doctor immediately)

• If after you have suffered a seizure you again experience a second one immediately or within a gap of a few minutes

• If you are also running a high temperature at the time that you got the seizure

• If you are feeling an exhaustion or fatigue that makes you feel hot all over and sweat

• If you also suffer from diabetes

• If you have suffered an injury when you had a seizure, such as if you fell and hurt yourself. Even if you cannot see any visible marks of injury, it is possible that you did suffer some injury when you fell. Go to a doctor as soon as possible to make sure your baby is also doing fine.

Are There Any Epilepsy Drugs That Are Safe To Be Taken During Pregnancy?

Unfortunately, there is still no clear indication of any drugs that you can take for epilepsy that are also safe to be taken while you are pregnant. There are no anti-seizure drugs that are completely safe or will not cause any effect on your unborn baby or you while you are pregnant. However, there are a few anti-seizure medications that may have a higher amount of negative impact on your unborn baby or you. It is important for you to speak to your doctor the moment you know you are pregnant, to know what changes you can make in your anti-seizure medications.

Here are a few anti-seizure epilepsy medications that you should have a detailed talk with your doctor about:

1. Depakote And Depakene:

The two anti-seizure drugs, known as Depakote and Depakene, have some of the highest risks of causing damage to your unborn baby. The two drugs are particularly at a high risk of causing neural tube defects in your unborn, such as spina bifida.

2. Phenobartbitol:

Your doctor will most likely ask you to change your medication and instead try out phenobarbitol throughout your pregnancy months. The particular drug seems to have a lesser risk of causing any damage to your unborn baby or you, as compared to the two high-risk drugs mentioned in the point above.

3. Tegretol, Lamictal, And Carbatrol:

A few more drugs that are thought to carry the least amount of risk to your unborn baby are the drugs Tegretol, Lamictal, and Carbatrol. The three drugs apparently carry an even lower risk to your unborn baby or you as compared to Depakote or phenobarbitol.

It is extremely difficult to recommend which anti-seizure drugs have a lesser risk during pregnancy and which ones come with a higher risk, as research and results are constantly changing in this area. It is very important for you to discuss all this in detail with your doctor before you take any medication that are meant to treat your epilepsy-related seizures or symptoms [2].

Making Some Important Changes Related To Epilepsy Medication During Pregnancy?

Here are a few tips you can follow that will help you combine your epilepsy treatment with your pregnancy:

1. The first step is to speak to your doctor about your epilepsy condition and your pregnancy. Your doctor will most likely ask you about your epilepsy and any related seizures.

2. If you are still planning to conceive, speak to your doctor to know if you need to change some medication and replace them with some different anti-seizure drugs.

3. Alternatively, your doctor may feel that it is fine to stick with the medication you are currently taking and that there is no need to change it for now.

4. In case you are on a prescription of more than one anti-seizure drugs, your doctor may want to review them both and ask you to take only one, which your doctor will suggest you. Taking anti-seizure or epilepsy drugs in a combination will make the risks higher for side effects to your unborn baby and you, because of which your doctor will want to bring it down to any one drug.

5. Ideally, the best time to make the change in your anti-seizure or epilepsy drug is at least a year before you want to get pregnant. Making a change in your medication can also pose a risk to your overall health. In some cases, your body may find it difficult to adjust to the sudden change and may react in an adverse way. You may find it difficult to respond to the new or changed treatment and may experience seizures that are more frequent and more severe in nature. Such a sudden change in your seizures could pose a high risk to your pregnancy and may cause irreparable damage to the unborn baby.

6. When you are thinking of changing or stopping some anti-seizure or epilepsy medication, your doctor will first introduce the new drug and then stop the other one. It will help you be on medication and avoid any sudden situation when you are without medication and may suffer a severe episode of seizure. Being pregnant at this time could be a high-risk situation, as your baby will be exposed to not just one high-risk drug but two.

7. Whether or not your doctor asks you to change your anti-seizure or epilepsy drugs, it is important for you to definitely add your folic acid medication when you are pregnant. In fact, it is always best to start taking your daily dosage of folic acid as soon as you plan to conceive. Folic acid can greatly reduce the chances of a birth defect by almost 60 to 70 percent.[3]

Situations To Avoid If You Suffer From Epilepsy During Pregnancy:

Here are some situations that you should avoid when you suffer from epilepsy during pregnancy:

1. Avoid being in places where you have a chance of falling and getting hurt

2. Stay away from water bodies to avoid accidental falling and drowning

3. Avoid driving

4. Try to reduce stress and speak to your doctor if you experience stress or anxiety.

Causes Of Epilepsy:

There is no well-defined cause that leads to epilepsy. While almost half of the cases of epilepsy do not have any clear cause behind them, the other half may have one or more of the following as a cause:

1. Genetics:

Certain types of epileptic conditions are caused due to genetic reasons, where someone in the family is known to have been affected by the same. The conditions are based on the type of specific seizure that you may experience and what part of the brain it affects. However, it is also important to remember that genes do not lead to epilepsy but are only a partial cause of the same. In some cases, a particular type of genetic condition may make you more susceptible to certain environmental conditions, which may then trigger your epileptic seizures.

2. Trauma To The Head:

Suffering any trauma to the head, such as those suffered by an automobile injury or other such incidence, can lead to epilepsy.

3. Conditions Related To The Brain:

Various conditions related to the brain can cause an epileptic attack. Some brain conditions that may lead to epilepsy are stroke or tumor in the brain. In those who are over the age of 35, suffering a stroke can be one of the most common causes of epilepsy.

4. Infectious Diseases:

Certain infectious diseases can also put you at risk of suffering from an epileptic episode. Infectious diseases such as AIDS, meningitis or viral encephalitis can greatly increase your chances of epilepsy.

5. Injury At Prenatal Level:

While the baby is still developing inside the mother’s womb, the brain is especially sensitive, and any change or trauma can lead to brain damage. There are various factors that could lead to prenatal injuries, such as poor nutrition, alcohol and tobacco consumption during pregnancy. It can also occur when you suffer from an infectious disease during her pregnancy or even a deficiency of oxygen that can cause permanent damage. Damage to the brain at the prenatal level can lead to epilepsy after the baby is born.

6. Disorders Related To Development:

Certain developmental disorders, such as autism as well as neurofibromatosis, can highly increase your chances of being affected with epilepsy.

Symptoms Of Epilepsy:

As epilepsy happens due to the abnormal pattern of electrical activity in your brain, it can affect any action that your brain controls. Here are some of the most common symptoms of epilepsy that you may experience:

1. Confusion that is temporary or short term but may also affect you for a longer duration
2. A brief spell in which you may keep on staring at one particular object, without registering that you are doing so
3. Sudden jerking movements especially in your arms and legs that you may not have any control over
4. Losing your consciousness, brief spells of fainting or loss of memory
5. Psychic symptoms[4]

In most cases, your symptoms will vary depending on the severity of your seizures. If you have epilepsy, it is possible that all your seizures will be of the same intensity and frequency and hence your symptoms too will tend to remain the same most of the time. Your doctor will classify your seizures either as focal or as generalized. It will depend on how your abnormal brain activities start first.

Here is a brief look at the two types of seizures that your doctor may diagnose you with:

1. Focal Seizures:

A focal seizure is one where your seizure will occur as a result of an abnormal activity that takes place in just one part of your brain. Focal seizures are also known as partial seizures and are of the following two types:

A) Simple Partial Seizures:

Simple partial seizures are also known as focal seizures in which you do not lose your consciousness. When you suffer a simple partial seizure, you may feel a change in your emotions or your senses. There may be a distinct distortion in the way you smell, taste, hear, feel or even see things. You may also experience sudden jerking movements in your body, most likely in your arms or legs, and will have no control over the same. You may also spontaneously experience various sensory symptoms in your body, such as a sudden tingling feeling, see flashing lights or feel dizzy.

B) Complex Partial Seizures:

Complex partial seizures are also known as focal dyscognitive seizures in which you may lose consciousness or may not be entirely aware of what is happening. When you experience a complex partial seizure, you may be staring into the blackness without really looking at anything. You may also not be able to respond properly to the environment around you or circumstances that may need your attention. You may also keep repeating certain movements, such as swallowing, chewing, rubbing your hands together or even walking around in circles.

In many cases, the symptoms associated with focal seizures are confused with the symptoms of some other health conditions. Some conditions that have very similar symptoms to those of focal seizures are a migraine, narcolepsy (in which a person tends to fall asleep all the time) and other forms of mental illnesses.

2. Generalized Seizures:

A generalized seizure is one where your seizure will occur as a result of an abnormal activity that takes place in all areas of your brain. Generalized seizures are of the following six types:

A) Absence Seizures:

Absence seizures were earlier known as petit mal seizures. Such form of seizure is most common in children but may also occur in adults. When you experience an absence seizure, you tend to stare into space or may have very subtle and almost unnoticed movements in the body, such as smacking your lips or blinking your eyes. Absence seizures can often occur as part of a cluster of seizures and can result in your not being aware.

B) Tonic Seizures:

When you suffer a tonic seizure, it causes a kind of stiffness in your muscles. Tonic seizures mostly affect the functioning of your muscles in the back, the arms and even the legs. In most cases, you may tend to fall on the ground if the seizure affects your leg muscles and is especially dangerous if you are pregnant.

C) Atonic Seizures:

Atonic seizures are also known as drop seizures. When you suffer from an atonic seizure, you will lose any control of your muscles, which can make you fall to the ground and is especially dangerous while you are pregnant.

D) Clonic Seizures:

When you suffer from a clonic seizure, you will experience various jerking movements in your muscles that will fall into a rhythm or pattern. In most cases, a clonic seizure will affect the muscles in your face, arms, and neck.

E) Myoclonic Seizures:

When you suffer from myoclonic seizures, you will experience sudden and brief twitches or jerks in the muscles of legs and arms.

F) Tonic-clonic Seizures:

Tonic-clonic seizures were earlier known as grand mal seizures. Such forms of seizures are also the most dramatic form of seizures that occur during epilepsy. A tonic-clonic type of seizure will almost always make you lose your consciousness. It also makes your body go stiff, and you may also experience a shaking movement all over your body. In some cases, you may also lose any control over your bladder and may end up biting your tongue too.

While epilepsy is a serious condition, the right treatment at the right time can make a difference to your baby and you. Did you suffer from epileptic seizures during pregnancy? How did you cope? Tell us about it here.

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