Epilepsy is a neurological disorder effecting the nervous system characterized by repeated epileptic seizures. The seizures are caused due to the abnormal pattern of electrical activity in the brain. The body will move in an uncontrollable manner and the person also can be unconscious for a short period of time.
Epilepsy and pregnancy
Epilepsy’s effect on women is way different than that on men. Her menstrual cycles, pregnancy, and menopause which depends on the hormones are affected by epilepsy.

Does Epilepsy Affect My Chances Of Conception?

Yes. Getting pregnant with epilepsy is found to be more difficult. The fertility rate is much lower than normal. The reasons can be:

  1. Irregular menstrual cycle: An irregular menstrual cycle can occur as a result of frequent seizures or some medicines taken for epilepsy. This can cause the conceiving difficult
  2. Uncontrolled seizures: Having seizures around the time when the body prepare to ovulate, interrupts the signals from the brain that cause ovulation
  3. Anti-seizure drugs: Hormone level in the ovaries is affected by some type of anti-seizure drugs. This will affect the reproductive function. Some medicines used to treat seizures are found to contribute to infertility
  4. Anovulatory cycle: Menstrual cycle that does not release an egg is called anovulatory cycle. Women with epilepsy possess more anovulatory cycle than a normal woman
  5. PCOS: Polycystic ovarian syndrome is found to increase among the women with epilepsy. This condition is one of the main hindrances for conceiving

How Do Epileptic Seizures Affect Ovulation?

When the seizure starts in the temporal lobe of the brain which regulates the hormones, the hormone production is affected which in turn alters the ovulation. If a woman has seizures when she is about to ovulate, the whole process of ovulation may get altered.

I Am Epileptic. What Are The Steps That I Should Take Before Conceiving?

A planned pregnancy is a good option for an epileptic woman. There are a few steps that you should take before trying to conceive.

  • Discussion with a neurologist is the first among them. This should be done at least six months prior trying to conceive (if possible, one year earlier is highly recommended). This will help you to manage a safe pregnancy. Never stop using contraception before consulting your doctor
  • Minimizing the dosage of anti-epileptic drug (AED) to the lowest possible level and tapering down to just one anti-epileptic drug instead of two should be done at least six months prior to conception as your body has to adjust to the new level of medications before getting pregnant
  • Avoid smoking and intake of alcohols
  • As AED tends to affect the ability of your body to absorb folic acid, your doctor will recommend increasing the intake of folic acid supplement while you are trying to conceive and throughout your pregnancy

Should I Stop Anti-Epileptic Drugs During Pregnancy?

Never stop taking AED during pregnancy without a specialist’s advice as it will increase the risk of having breakthrough seizures. Your doctor is able to weigh the possible and probable effect of AED during your pregnancy and prescribe the needed well-balanced medication that could control your seizures. Remember, having a seizure during pregnancy can harm your child more than an AED will.
Pregnancy with epilepsy

What Is The Relation Between Hormones And Epileptic Seizures?

The problems that arise when epilepsy is combined with pregnancy are more often hormone based. Estrogen and progesterone are the two prominent hormones that have a significant role in a safe pregnancy. Both of these hormones interact with the brain cells. Estrogen, which promotes the electrical activities of the brain and progesterone, which calms the electrical activities of the brain.
When more estrogen is produced, there is a greater the risk of seizures.

What Happens When Epilepsy Goes Hand-in-hand With Pregnancy?

It is true that women with epilepsy have to overcome some significant risks during pregnancy that a normal woman doesn’t have to. But, if managed precisely and with proper guidance of your doctor, you can minimize those risks. The pregnant woman with epilepsy should be monitored by a high-risk obstetrician during their pregnancy.

What Are The Risk Factors That Epileptic Women Face During Pregnancy?

There are some risk factors faced only by epileptic women during their pregnancy period:

  • The most significant risk factor is the epileptic seizures. Falling down without a warning is highly dangerous and can cause trauma resulting in:
    • Preterm labor
    • Fetal injury
    • Premature birth
    • Placental abruption
    • Miscarriage
  • Any medication during pregnancy is risky. When the mother uses the anti-seizure medicines, the risk of major birth defects increases up to 6% (in normal cases, it is only 2%)
  • Babies born to an epileptic mother possess slightly higher risk of developing epileptic seizures as they get older
  • Children born to an epileptic mother who takes some kind of AED’s increases the risk of FACS – fetal anti-convulsant syndrome

How Can A Safe Pregnancy Be Ensured For An Epileptic Woman?

For the fifty percent of the women, the epileptic seizures will remain unchanged. Other twenty-five per cents of women is lucky enough to decrease the frequency of seizure. Last twenty-five per cent is unlucky enough to increase the frequency of the seizures.
Some of the measures that are taken for a safe and healthy pregnancy of an epileptic mother are:

  • Close monitoring of the mother and the child
  • Monthly monitoring of the AED level. Both total and free level of AED is monitored. This will help in maintaining seizure control
  • Extra ultrasound scan and blood tests are done to make sure the baby is having normal growth
  • Between 16th to 18th weeks of pregnancy, an epileptic mother will be screened to confirm against fetal malformations
  • The epileptic mother should take plenty of rest. Sleep deprivation is one of the reasons for the epileptic seizure
  • Follow a healthy diet

Epilepsy does not stop you from doing your daily activities, and the activities you love most provided a little extra care is given. This is applicable during your pregnancy period too.