Q: Doc I am one month pregnant and I am taking anti-epileptic drugs can they affect my babies?
A: Thanks for writing in and congratulations on your pregnancy! 😀
Before we go into what’s safe to use and what’s not, let’s describe epilepsy a bit.
Most of you have heard weird things about epilepsy. You have also most likely heard that it is contagious and so sharing cutleries, hugging and sitting close to epileptics puts you in the direct path of the problem, right? Wrong! Epilepsy is NOT contagious!!!
What is epilepsy? It is a problem of the nervous system where the cells of the brain ‘fire’ or behave abnormally leading to abnormal sensations, symptoms, behaviour and sometimes loss of consciousness. This is called a seizure but not every seizure is due to epilepsy. Seizures can occur in high fever (especially in children) and also due to dehydration. A seizure needs to have occurred at least on two different occasions without provocation for epilepsy to be suspected.
Symptoms of epilepsy would depend on the type of epilepsy (yes, there are different types). So, the person may not lose consciousness at all but may have altered taste, smell etc, there may also be jerky movements of limbs, staring gaze etc.
What are the possible causes of epilepsy? It could be due to genetics (having a relation with epilepsy places one at a higher risk. Also some genes are more likely to be affected by the other risk factors of epilepsy leading to seizures), infections like meningitis, antenatal conditions like poor feeding and infection in the mother, Trauma the head like in head injuries and other brain conditions like stroke. Other risk factors are extremes of age (Early childhood and adults more than 60 years are more likely to have this. However, this is not a hard and fast rule as this has been observed across different age bands) and prior history of seizure in childhood.
Some people may have found out that a seizure is usually provoked by certain things or situations. These triggers include flashing bright lights, stress, sleep deprivation, during monthly menstrual cycle, certain foods, alcohol or certain drug use, poor feeding etc. Sometimes, it is not very easy to recognize these triggers if you are not looking out for them. So, paying attention to the ‘possible’ triggers is important so they can be avoided.
Treatment can range from taking drugs to surgery…or perhaps other forms of treatment. These drugs can either get a person to the point where they never have seizures again or to the point where they have fewer seizures. But please, do not discontinue the drugs. This can be done only with your doctor’s advice as it has to be timed right.
To cope with this long term, ensure that drugs are taken as prescribed and discuss with your doctor if you feel dose needs to be amended. Get enough sleep and generally avoid other triggers of seizures, exercise regularly and make healthy lifestyle choices.
If you are not epileptic or if you don’t know anyone with epilepsy, you probably don’t think you have an action point here. But you do! Epileptics suffer all manners of indignity. They are accused of witchcraft, their feet are burned to get rid of the witchcraft etc. But none of this is true. Help spread the story that epilepsy is NOT witchcraft, is not contagious and epileptics are normal human beings who have suffered enough exclusion and need our love, support and care. We need to teach our children this too as epileptics in schools suffer severe emotional, mental and oftentimes, physical torture/bullying from other kids in school. This could very well be because their parents have told them to steer clear of any child with a seizure. You and I can change this!
Now, to your question about epilepsy in pregnancy….
There is conflicting information about what epilepsy medications are safe to take in pregnancy because of the risk of malformation of the baby. The jury is still out and your doctor will really need to individualize your treatment for you. But it is known that the drug Valproic acid used for treating epilepsy appears to have the highest risk of causing malformations in the unborn baby. Your doctor may decide to switch drugs for you or alter the dosage. It is important though that you start preparing for pregnancy even before you get pregnant by taking folic acid tablets. Now that you are already pregnant, continue to do same under the direction of your doctor as it will help reduce the risk of birth defects.
Can one have a seizure during pregnancy? It is possible especially as the volume of blood increases during pregnancy leading to dilution of the effect of the anti-epileptic drugs you are taking. Your doctor may have to increase the dose of your medication. If a seizure happens during labour, you may be given intravenous (IV) anti-epileptic drugs. This could affect the contraction of your womb and so the doctor may opt for Caesarian Section.
But women who suffer from epilepsy can also go through pregnancy with no issues. Just ensure that you register in a good center with a good obstetrician and you should be fine. Let us know when you deliver your bundle of joy 😀
All the best!
Have a great weekend, y’all 😀
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