Authors :
Christine Ochoa, MD – Orlando Health
Presenting Author: Adriana Pina, CCMA – Orlando Health
Jayden Carlo, BS3 – University of Alabama
Dipali Nemade, MD, MPH – Orlando Health
Rationale:
Epilepsy management during pregnancy presents unique challenges, as the selection for anti-seizure medication (ASMs) must balance the need for maternal seizure control with fetal safety. The most commonly used ASM during pregnancy includes Lamotrigine, Levetiracetam, and Oxcarbazepine, as shown in comparative studies by Cerulli Irelli et al. (2023) given their favorable safety profiles. Based on the safety of Levetiracetam, Brivaracetam (BRV) may be similarly safe in pregnancy; however, very limited literature or data exists about its safety.
This case report illustrates the safety of BRV in a pregnant patient with generalized epilepsy who delivered a healthy baby boy with no breakthrough seizures during pregnancy and after the delivery.
Methods:
PubMed Search was used for review of literature, including the following search tags: “Briviact”, OR “Brivaracetam” AND, IN “Pregnancy”. We found 8 articles, out of which 7 were excluded because these were not relevant for our search; only 1 article was included, case series by Paolini et al. (2020).
Additionally, after obtaining informed and written consent from the patient, her electronic medical record was reviewed including the electroencephalogram (EEG).
Results:
We present a 35-year-old RH female with PMH of generalized epilepsy and hypertension, who presented to our clinic for seizure management at 17 weeks of her pregnancy. She was on Brivaracetam 100 mg daily prior to presentation to our clinic. Her dosage was adjusted to 50 mg QAM and 100 mg QPM and along with folic acid