Women and Epilepsy

By Dr. Sushma Sharma in Neurosciences Neurology

Nov 14, 2018

Women and Epilepsy: Key Questions Answered

Why Do I Have Seizures Around My Period?
Some women experience catamenial epilepsy, where seizures align with the menstrual cycle due to hormonal changes. Estrogen tends to promote seizures, while progesterone can suppress them. A healthcare provider may suggest treatments like acetazolamide, hormonal therapy, or additional medication alongside antiepileptic drugs.

Do Birth Control Pills Affect Seizures?
Generally, birth control pills do not impact the effectiveness of antiepileptic drugs or increase seizure frequency. However, since both oral contraceptives and certain antiepileptic drugs are processed by the liver, there’s a chance that each could influence the other’s metabolism, so consult with your doctor for guidance.

What Medications Are Best for Seizures During Pregnancy?
The most effective antiepileptic drug in pregnancy is the one that controls seizures with the least side effects. Women should work closely with their neurologist to find the best option for seizure control.

How Does Pregnancy Affect Seizures?
Seizure frequency may increase in pregnancy, partly due to medication changes or discontinuation, which is usually not advised. Additionally, pregnancy can impact medication absorption and metabolism, resulting in lower drug levels. Regular check-ins with both obstetrician and neurologist are vital for managing epilepsy effectively during pregnancy.

Should I Discontinue Epilepsy Medication If I’m Pregnant?
Stopping medication is usually not recommended as uncontrolled seizures may pose a greater risk than the small chance of birth defects, which occurs in about 6% of pregnancies for women with epilepsy. Any medication changes should be guided by your doctor.

Can Birth Defects Be Detected?
Yes, screening like alpha-fetoprotein tests and ultrasounds (typically around 18 weeks) can check for potential birth defects.

What Can I Do for a Healthy Pregnancy?
Planning ahead can improve outcomes. Start prenatal vitamins, including folic acid, eat a nutritious diet, get adequate rest, and avoid alcohol, drugs, and cigarettes.

Can Seizures Occur During Delivery?
While rare, about 1-2% of women with epilepsy may have a seizure during labor. These can be managed in the delivery room with IV medications.

Can I Breastfeed?
Most epilepsy medications appear in breast milk but are generally safe for breastfeeding. Consult your doctor for personalized advice.

For expert epilepsy management, consult a trusted neurologist and seek comprehensive care.