Abstracts

The prognosis for seizures with onset during pregnancy is generally thought to be infrequent seizures and epilepsy which is easily controlled with medication. This limited information has been used to counsel patients with seizure onset during pregnancy. The objective of this study is to describe a small cohort of patients with seizure onset during pregnancy in which the majority developed medically intractable epilepsy.
100 case histories of female patients with seizures in our outpatient epilepsy clinic were reviewed to identify those with seizure onset during pregnancy and analyze the degree of seizure control and quality of life issues.
Five patients (5%) were found to have a history of new onset of seizures during pregnancy. None of these patients had systemic illnesses at the time of diagnosis. One had evidence of mesial temporal sclerosis on MRI. Neurological exam was normal in all five patients.Three of the five patients developed medically intractable seizures. They underwent epilepsy surgery after an average of nine years (range 3 - 15 years) with complete control of their seizures postoperatively. Attempts to discontinue medications have been unsuccessful in the other two patients.Two of the five women went on to have other children. One patient became pregnant after left temporal lobectomy. None of the patients was employed outside the home at last follow up but all are driving.
The prognosis for seizures with onset during pregnancy is not always favorable. Although our sample is small, these results point to the importance of careful and qualified follow up. Further studies of this particular population are needed in order to continue to enhance our understanding of the role gender and pregnancy play in epilepsy and continue to improve the lives of our patients.