Abstracts

RATIONALE: Patients with epilepsy have been estimated to constitute 0.3 to 0.7% of all pregnancy. Patients with epilepsy are at substantial risk for a variety of complications during pregnancy. The objectives are: i)to evaluate the changes in seizure frequency during pre-gestational, pregnancy and puerperium periods, and ii) to identify factors related to increase in seizure frequency.
METHODS: We followed 50 pregnant women with epilepsy prospectively. The mean age was 25 years (range 16 - 45), and the mean duration of epilepsy was 11 years (range from 7 months to 37 years). Nine had symptomatic, 35 had probably symptomatic, and six had idiopathic epilepsies. All patients were evaluated every 60 days. Forty-seven were keeping with the same pre-gestational anti-epileptic drug (AED). Three had no AED therapy. Drug dosages were increased to control tonic-clonic seizures in seven patients. Forty-one patients were on monotherapy and six on two AEDs. The subjects were classified according to seizure frequency into six groups based on modified report of Milan study (CANGER et al., 1982).
RESULTS: The seizure frequency in 23 patients (46%) remained unchanged, in 14 (28%) worsened and in 13 (26%) improved. Comparison of seizure frequency among prepregnancy, gestational and puerperium periods showed no difference (Friedman, p=0.073). We found no significant correlation in seizure frequency during pregnancy and risk factors such as type of seizure and epilepsy, aetiology, age, duration of epilepsy, prepregnancy seizure frequency, type of AED and its serum levels and electroencephalogram abnormalities. None of patients had status epilepticus.
CONCLUSIONS: Gestational and puerperium periods did not influence seizure control.