The effect of menstruation on seizure frequency. The interaction between anticonvulsant drugs and oral contraceptives. The effects of anticonvulsant drugs on the fetus.

Some mothers report that their seizures become more frequent, others less frequent during pregnancy, and others have seizures which remain more or less unchanged in pregnancy. There seems no way of predicting what is going to happen in the first pregnancy, except that those with very frequent seizures are unfortunately, likely to get worse. By and large, subsequent pregnancies in any one mother follow much the same pattern. An unexpected and totally unexplained finding has been that those pregnant with a male baby are rather more likely to have more frequent seizures. Although epilepsy may start for the first time during pregnancy, this usually seems to be coincidental, and there is no good evidence that pregnancy itself is a

particularly potent event in inducing seizures. One possible reason for an increase in frequency of seizures during pregnancy is that the body processes anticonvulsant drugs differently. The interactions between pregnancy and drug metabolism may be complex.

Some anti-epileptic drugs pass through the placenta into the fetus. Phenobarbitone is perhaps the best-known example. After delivery the baby’s serum phenobarbitone falls, and during the early days after birth the baby may be much more fractious and irritable than most new-born babies.

Many mothers on anti-epileptic drugs wonder whether they can breast-feed their babies. Careful studies have been made on this point, and only small quantities of the drugs are secreted into milk, so it is quite safe to breast-feed.


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