epilepsy

Question 1

Epilepsy definition

Answer 1

Is the presence of recurrent, unprovoked
seizures due to excessive neuronal discharge

** Is the most common neurological disorder in
pregnancy

Risk for death is increased 10 folds compared by
non-epileptic pregnant

• Start on high dose folic acid 5 mg before 3
  months of pregnancy

Question 2

Anti Epileptic drugs in pregnancy (safe or not )

Answer 2

1)lamotrigin,levetiracetam (safe in pregnancy )

2) carbamazepine , oxcarbazepine ,zonisamide (less safe than n.1)

3) phenytoin , phenobarbital ,topiramate

4 ) valproic acid (depalept ) (highest teratogenic risk 5% )

Question 3

Most common congenital malformation:

Answer 3

• neurodevelopmental
• cognitive dysfunction
• neural tube defects
• cardiac defects
• cleft palate

Question 4

epilepsy control during labor

Answer 4

Aim for vaginal delivery , in order to decrease risk for seizure, avoid the following

pain
o sleep depriviation
o stress
o dehydration

Question 5

If seizure occurred in labor, what to do

Answer 5

ABC
o Left lateral position
o Benzodiazepines are the drug of choice ( lorazepam or diazepam