In the May issue of the journal, Epilepsia, Doctors Thomas and
colleagues from the department of Neurology at the Sree Chitra Tirunal Institute
for Medical Sciences and Technology in Trivandrum, India, reported results of a
study that aimed to assess when seizures are likely to occur in women who have
epilepsy and what are some of the factors that help to predict if seizures are
likely to occur. Using the Kerala Registry of Epilepsy and Pregnancy, which is a
registry of patients with epilepsy who became pregnant, the study profiled 1297
pregnancies in women with epilepsy who had complete records. The specific aim of
the studies was to establish the timing of when seizures were most likely to
occur and what were those predictors during pregnancy.
Drawing from the data…
The investigators found from the registry samples that 47.8% were seizure
free during their pregnancy. The seizure relapse of the individuals who had
seizures was highest during the three days in and around the actual delivery of
the baby. Women with seizures that were of partial onset had a higher risk of
relapse than those who had generalized seizures. There were two peaks at which
seizures were likely to occur:
- The second to third month and;
- The sixth month of pregnancy in women who had partial epilepsy.
And some other findings…
- Patients who had generalized seizures had one peak at which seizures were most likely to occur and that was within the first trimester;
- Those who were on more than one drug had an increased risk of seizures as compared to those who were on just one seizure medication and;
- Those who had seizures in the month prior to pregnancy had a higher risk of seizures during pregnancy as compared to those who were seizure free during that period.
Which means…
When looking at the various factors in terms of predicting seizures, it
appears that pre-pregnancy seizures is the most important
predictor as to whether a woman will have seizures during her
pregnancy.
The importance of this is that although much is written about predicting what
are the effects of exposure to seizure drugs in women who are pregnant, this
study helps to look at the timing of seizures during pregnancy and to identify
those pregnant women who are most at risk for seizures.
This is interesting why?
It illustrates the importance of a pregnancy registry and the useful
information that can be obtained from it which can help better guide health
standards and access to healthcare. This study also could be utilized if
replicated to at least look for closer observation for those women who have
pre-pregnancy seizures immediately before their pregnancy so that better
evaluation of their drug levels can be done in order to prevent seizure during
pregnancy.
by Joseph I. Sirven, MD
Editor-in-Chief, epilepsy.com
Last Reviewed: 6/20/2012
Editor-in-Chief, epilepsy.com
Last Reviewed: 6/20/2012
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