Seizures and Pregnancy

Seizure disorders affect more than one million women of childbearing age. Epilepsy can cause fetal and maternal morbidity, and the use of antiepileptic drugs (AEDs) is also associated with an increase on fetal and maternal complications. Critical care clinicians must exercise caution when controlling seizures and attempt to maintain full control of epileptic attacks while minimizing exposure to possibly teratogenic drugs. Maintaining drugs at therapeutic levels during the altered pharmacokinetics of pregnancy is also challenged by the decreased compliance by patients and the reluctancy of prescribing them by the clinicians. Seizure activity could be primary or secondary. Structural, metabolic, hematologic, infectious, and even psychogenic causes must always be considered in every patient. Especial attention must be focused to preeclampsia and eclampsia, highly morbid and even lethal for both the mother and the fetus. The role of some of the medications and the effectiveness of some therapies have been the object of multiple literature reviews.