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Other types of anticonvulsants and pregnancy

A few patients may be maintained on Valproic acid (Epilim®) and Trimethadione (Tridione®). These are not commonly used. If a patient is on one of these, it may be changed to a safer variety such as carbamazepine.

Both Trimethadione and Valproic acid have been associated with a variety of birth-defects and Valproic acid is notorious for causing spina bifida and other defects of the spinal column. Valproic acid is also known as Sodium valproate.

The decision to change medication is not always automatic or straightforward since the person may have tried the apparently safer alternatives in the past with disappointing results. Alternatively, she might have a history of seizures that are very difficult to control and her doctors may judge it unsafe to take the gamble.

Lamotrigine (Lamictal®). This anti-epileptic taken on its own is considered to be relatively low risk compared to other anti-epileptic medications. The risk is significantly increased when taken in combination with such drugs as Valproic acid (Epilim®) as is the case sometimes.

Vigabatrin (Sabril®) has also been associated with birth defects and the standard advice is to avoid in pregnancy unless the benefits are deemed to outweigh risks.

As a rule, anybody taking any of the anti-epileptic drugs should not stop without consulting her doctor first.

Other precautions to be taken by the epileptic mother during the course of the pregnancy

Anticonvulsant (anti-epileptic) medication makes the epileptic mother vulnerable to developing a folic acid deficiency. Folic acid will be recommended as a supplement, preferably throughout the course of pregnancy.

Also, there is a small risk of bleeding (for the baby) and doctors will advice taking Vitamin K1 (Konakion®) supplements towards the end of pregnancy to prevent this.

Hereditary effects of epilepsy

When the father of the baby is epileptic

Paternal epilepsy is also a risk factor for fetal anomalies. The risk of fetal malformations as a result of parental epilepsy is roughly the same if one or the other parent is epileptic.

However, if the father is the affected parent, the baby will not be at risk of the malformations associated with anti-epileptic medication.

Chances of the baby developing epilepsy himself or herself, later on in life

It is estimated that approximately 10% of babies born to an epileptic parent will go on to develop epilepsy themselves. Again, this is regardless of which parent is affected. Conversely, it is important to remember that 90% of all children born to an epileptic parent will not be affected by this condition.. The issue of risk to children by virtue of their parents’ epilepsy is still a matter of debate.

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