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The course of epilepsy and seizure control in pregnant women

  • Melikova Shahla
  • Bagirova Hijran
  • Magalov Sharif
Original Article

Abstract

To investigate the course of epilepsy and seizure control during pregnancy. 105 pregnant women with epilepsy were studied prospectively during the period from 2013 to 2017. The average age at the onset of epilepsy was 17.4 ± 0.5 years. Seizures during pregnancy were observed in 76 (72.4 ± 4.4%) women. Eleven (10.5 ± 3.0%) women had their first seizure during current pregnancy. Among those 94 women who were diagnosed with epilepsy before pregnancy, 29 (30.9 ± 4.8%) remained seizure free; seizure frequency increased in 27 (28.7 ± 4.7%), decreased in 24 (25.5 ± 4.5%) women, in 14 (14.9 ± 3.7%) remained unchanged. Among 15 women who were seizure free for the 1 year prior to pregnancy 11 (73.3 ± 11.4%) women remained seizure free during pregnancy. The worsening in seizure control during pregnancy occurred in 22 (35.5 ± 6.1%) of 62 women with focal epilepsy and 5 (15.6 ± 6.4%) of 32 with idiopathic generalized epilepsy (OR 2.97, 95% CI 1.0–8.81). Non-compliance with the antiepileptic drug therapy was observed in 20 (19.0 ± 3.8%) pregnant women, seizure frequency increased in 18 (90.0 ± 6.7%) of them compared with 5 (9.8 ± 4.2%) of 51 of those who followed correct antiepileptic drug regimen (p < 0.001). The risk of seizures during pregnancy was lower in women who were seizure-free for the 1 year prior to pregnancy; focal epilepsy was associated with an increased risk of seizure relapse during pregnancy; non-compliance with the antiepileptic drug therapy and inappropriate treatment may lead to worsening of seizure control and to the status epilepticus during pregnancy.

Keywords

Antiepileptic drugs Epilepsy Pregnancy Seizures 

Notes

Compliance with ethical standards

Conflict of interest

None of the authors has any conflict of interest to disclose. We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

Ethical approval

All procedures performed in the study were in accordance with the 1964 Helsinki declaration and its later amendments.

Informed consent

All participants provided informed consent prior to their participation.

References

  1. 1.
    Morrell MJ (2002) Epilepsy in women. Am Fam Physician 66(8):1489–1494PubMedGoogle Scholar
  2. 2.
    Tomson T, Battino D, Bonizzoni E et al (2011) EURAP study group. Dose-dependent risk of malformations with antiepileptic drugs: an analysis of data from the EURAP epilepsy and pregnancy registry. Lancet Neurol 10(7):609–617CrossRefPubMedGoogle Scholar
  3. 3.
    Borgelt LM, Hart FM, Bainbridge JL (2016) Epilepsy during pregnancy: focus on management strategies. Int J Womens Health 8:505–517CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Patel SI, Pennell PB (2016) Management of epilepsy during pregnancy: an update. Ther Adv Neurol Disord 9(2):118–129CrossRefPubMedGoogle Scholar
  5. 5.
    Schmidt D (1982) The effect of pregnancy on the natural history of epilepsy. A review of literature. In: Janz D, Dam M, Bossi L, Helge H, Richens A, Schmidt D (eds) Epilepsy, pregnancy, and the child. Raven Press, Ltd., New York, pp 3–14Google Scholar
  6. 6.
    EURAP Study (2006) Seizure control and treatment in pregnancy: observations from the EURAP Epilepsy Pregnancy Registry. Neurology 66:354–360CrossRefGoogle Scholar
  7. 7.
    Thomas SV, Syam U, Devy JS (2012 May) Predictors of seizures during pregnancy in women with epilepsy. Epilepsia 53(5):85–88CrossRefGoogle Scholar
  8. 8.
    Harden CL, Hopp J, Ting TY et al (2009) Management issues for women with epilepsy—Focus on pregnancy (an evidence based review): I.Obstetrical complications and change in seizure frequency: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Epilepsia 50:1229–1236CrossRefPubMedGoogle Scholar
  9. 9.
    Bardy AH (1987) Incidence of seizures during pregnancy, labor and puerperium in epileptic women: a prospective study. Acta Neurol Scand 75:356–360CrossRefPubMedGoogle Scholar
  10. 10.
    Tanganelli P, Regesta G (1992) Epilepsy, pregnancy, and major birth anomalies: an Italian prospective, controlled study. Neurology 42(4 Suppl. 5):89–93PubMedGoogle Scholar
  11. 11.
    Tomson T, Lindbom U, Ekqvist B, Sundqvist A. Epilepsy and pregnancy: a prospective study of seizure control in relation to free and total plasma concentrations of carbamazepine and phenytoin. Epilepsia 35(1):122–130 (1994)CrossRefPubMedGoogle Scholar
  12. 12.
    Ozdemir O, Mustafa E, Sari A, Kurt et al (2015) Pregnancy outcome of 149 pregnancies in women with epilepsy: experience from a tertiary care hospital. Interv Med Appl Sci 7(3):108–113PubMedPubMedCentralGoogle Scholar
  13. 13.
    Viinikainen K, Heinonen S, Eriksson K, Kalviainan R (2006) Community—based, prospective, controlled study of obstetric and neonatal outcome of 179 pregnancies in women with epilepsy. Epilepsia 47:186–192CrossRefPubMedGoogle Scholar
  14. 14.
    Battino D, Tomson T, Bonizzoni E et al (2013) Seizure control and treatment changes in pregnancy: observations from the EURAP epilepsy pregnancy registry. Epilepsia 54(9):1621–1627CrossRefPubMedGoogle Scholar
  15. 15.
    Thomas SV (2006) Management of epilepsy and pregnancy. J Postgrad Med 52(1):57–64PubMedGoogle Scholar
  16. 16.
    Yakunina AV, Poverennova IE, Veldiaksova ED (2017) The peculiarities of the focal epilepsy during pregnancy and after childbirth. Sib Med Rev 2017(1):63–69CrossRefGoogle Scholar
  17. 17.
    van Loenen NTVM et al (2004) New onset seizures in pregnancy caused by an unexpected neurologic disorder. Eur J Obstet Gynecol Reprod Biol 10(1):109–111CrossRefGoogle Scholar
  18. 18.
    Sveberg L, Svalheim S, Taubøll E (2015 May) The impact of seizures on pregnancy and delivery. Seizure 28:35–38CrossRefPubMedGoogle Scholar
  19. 19.
    Beach RL, Kaplan PW (2008) Seizures in pregnancy: diagnosis and management. Int Rev Neurobiol 83:259–271CrossRefPubMedGoogle Scholar
  20. 20.
    Gjerde IO, Strandjord RE, Ulstein M (1988) The course of epilepsy during pregnancy: a study of 78 cases. Acta Neurol Scand 78(3):198–205CrossRefPubMedGoogle Scholar
  21. 21.
    Vajda FJE, Hitchcock A, Graham J et al (2008) Seizure control in antiepileptic drug-treated pregnancy. Epilepsia 49(1):172–176CrossRefPubMedGoogle Scholar
  22. 22.
    Schmidt D, Canger R, Avanzini G et al (1983) Change of seizure frequency in pregnant epileptic women. J Neurol Neurosurg Psychiatry 146:751–755CrossRefGoogle Scholar
  23. 23.
    Wu M, Hao N, Yan B, Chi X, Zhou D (2016) Status epilepticus in pregnant women with epilepsy after valproate adjustment: a case series. Seizure 43:39–41CrossRefPubMedGoogle Scholar
  24. 24.
    Kasai M, Aoki S, Kobayashi N, Hirahara F, Takahashi T (2016) Status epilepticus due to brain tumor during pregnancy. Clin Case Rep 4(4):333–335CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Belgian Neurological Society 2018

Authors and Affiliations

  • Melikova Shahla
    • 1
  • Bagirova Hijran
    • 2
  • Magalov Sharif
    • 1
  1. 1.Department of NeurologyAzerbaijan Medical UniversityBakuAzerbaijan
  2. 2.Department of Obstetrics and Gynecology IIAzerbaijan Medical UniversityBakuAzerbaijan

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