Seizure Disorders

Seizure Disorders

Epileptic women contemplating pregnancy who have not had a seizure for 5 years should consider a prepregnancy trial of withdrawal from treatment. Those with recurrent epilepsy should use a single drug with blood level monitoring. Trimethadione and valproate are contraindicated during pregnancy; phenytoin and carbamazepine may be teratogenic in the first trimester and should not be used unless absolutely necessary. There is limited information available on the safety of newer antiepilepsy drugs (eg, lamotrigine), and they should generally be avoided.

Phenobarbital is considered the drug of choice. Serum levels should be measured in each trimester and dosage adjustments made to keep serum levels in the low normal therapeutic range. Pregnant women taking phenobarbital and phenytoin should receive vitamin supplements, including folic acid and vitamin D, throughout pregnancy. Vitamin K, 10-20 mg/d, is administered during the last month to help prevent bleeding problems in the newborn, who is at risk of bleeding tendencies due to decreased levels of clotting factors. Such infants should receive an injection of vitamin K1, 1 mg subcutaneously immediately after delivery, and should have clotting studies 2-4 hours later. Breast feeding is not contraindicated for infants of mothers taking antiseizure medications.

RELATED STORIES:
Tuberculosis   Syphilis, Gonorrhea, & Chlamydia trachomatis Infection   Heart Disease   Asthma   Urinary Tract Infection   Thyroid Disease   Varicella   Group B Streptococcal Infection   Maternal Hepatitis B & C Carrier State   Acute Fatty Liver of Pregnancy   Peripartum Cardiomyopathy   Herpes Genitalis   Hypertensive Disease   Diabetes Mellitus   AIDS During Pregnancy

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]