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Have Epilepsy, Taking Eptoin, Planning To Conceive By IVF. Can An Epilepsy Attack Happen During Pregnancy?

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Posted on Tue, 10 Jul 2012
Question: Hello Doctor,
I am suffering from EPILEPSY since last 12 years. But the attacks are very much subsided since then. Now the attack lasts for just 4-5 seconds. For that 4 secs, i experience tremendous headache, my body becomes stout. Then i am normal to do my daily chores. Although my body aches on that day, then next day everything is routine.
It used to happen once or twice in a year. Now i dint experience since a year. i observed that - this happens when i miss the dose consecutively for some days. Last major attck happened 2 years back post operation when i had undergone through a major fibroid open surgery. This happened after gap of 5 years. I guess, it happened as i had to take heavy antibiotics on empty stomach while recovering. Although, i had everyday taken the tablets prescribed by doctor. (two Encorate Chrono300mg & two Frisium-5 per day). Then the doctor told me to take eptoin for a month. Then after 6 months he gradually stopped my Encorate n Frisium5 tablets n instead gave me Levroxa 500mg (twice a day). Now i am perfectly fine. I work as a Manager at a MNC & i manage my work efficiently, thus it does not affect me in day to day life.
Now the reason that i need your advice is - I am planning to conceive by IVF. Please guide.
Can the epilepsy attack happen during pregnancy? Will it affect my baby?? Will the consumption of Levroxa tablets (Levetiracetam) can have adverse effect on baby??? My Neurologist had stopped Encorate Chrono (Sodium Valproate) & started Levroxa stating that these will not have adverse affect on the fetus. Pls help me with your guidance as i am very nervous with the articles on internet which states that anti-epileptic drugs can harm fetus.
I am very desperate to have a baby, and a healthy one. Can the Epileptic mothers have normal babies??
doctor
Answered by Dr. Pratap Sanchetee (18 hours later)
Dear,

As your seizures are not fully controlled, we need to continue antiepileptic drugs (AEDs) for minimum 3 years seizure free period.

1 Ideally pregnancy should be planned after seizures are controlled and one is off AEDs. Sometimes it may not be possible as in your case.

2 Can the epilepsy attack happen during pregnancy? Yes, it can occur but chances are less if one is on AEDs

3 Can it have adverse effect on pregnancy and baby? Yes. It has not been studied extensively in human. It carries a small risk of adverse effects on the fetus and pregnancy

4. You will have to take a calculated risk after consulting your neurologist and obstetrician. If you decide for pregnancy regular antenatal care is must.

All the best.

Pratap

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Pratap Sanchetee (1 hour later)
Thank you for your answer Sir.
As suggested by you, i would not be able to wait anymore to conceive as the age factor is not in my favor.
Please suggest- are Levroxa tablets (Levetiracetam) safe in pregnancy - For me & for baby?
If there are some counterdrugs present so that it can keep the baby safe from the adverse effect of antiepileptic drugs, pls help with that.
My doctor has given Folic acid, but is it enough to save the baby from abnormalities, if any?
Please guide me for safe pregnancy & delivery. I want my baby to be healthy. Pls help. I really need some advice on the same.
You must have handled cases with pregnant epileptic mothers, what is the ratio of healthy babies?
I am ready to take any treatment for a healthy baby.
doctor
Answered by Dr. Pratap Sanchetee (23 hours later)
Hi,

Thanks again.

I understand your concern. The following are my answers to your queries.

1. Are Levroxa tablets (Levetiracetam) safe in pregnancy - For me & for baby?
- There are no enough clinical studies that have not been done to answer your query. We have few animal studies have shown comparable risk with other AED's but not on levetiracetam. So in this context, your doctor needs to consider the benefits and risks of this drug. If the benefits outweighs risk (as it appears now) you would need to continue the pills.

2. If there is some counter drugs that can keep the baby safe from adverse effects of AED's?
- Currently there are no specific drugs as to counter all the effects of AED's.

3. Regarding folic acid, folic acid provides some safety against few but not all bad effects of AEDs. Extent of benefit is also not established.

4. I appreciate your efforts to seek medical guidance for safe pregnancy and normal delivery. All you need is regular antenatal check up and sonography during pregnancy. It can be performed as many number of times as desired in your case. Continue with folic acid pills. An episode of convulsion during pregnancy can cause more harm to pregnancy and growing fetus than AED's, so you would need to continue AED's as suggested by your doctor.

5. Approximately 95-97% of babies will be normal as per experience throughout world. So do not worry.

Hope this helps.

I wish you good luck. Let me know if you have any more queries.
If all your queries are answered, please close this discussion.

Good wishes

Dr. Pratap

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Pratap Sanchetee (4 hours later)
Thank you Dr XXXXXXX for your valuable advice & guidance. I will surely keep myself updated with the USG & antenatal check up during the development of the fetus on pregnancy.
It really has given me a XXXXXXX of hope when u stated that 95-97% babies are normal.
Only last basic Question is
1. Is Levroxa 250mg in morning & 500mg at night (750mg/day) is comparatively a acceptable dosage in pregnancy or is it very high, while safety n health of fetus is concerned?

Thank you again.
doctor
Answered by Dr. Pratap Sanchetee (19 hours later)
Dear,

These dosages are not high. Rather they are on lower side of the range. However, it would be unethical and inappropriate to prescribe you scheduled drugs without doing a proper examination.

Today’s research indicates that a move toward individualizing the dosing of prescription agents is warranted and it can happen only after physical consultation / your doctor will know about these drugs.

Thanks

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Pratap Sanchetee

Neurologist

Practicing since :1974

Answered : 125 Questions

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Have Epilepsy, Taking Eptoin, Planning To Conceive By IVF. Can An Epilepsy Attack Happen During Pregnancy?

Dear,

As your seizures are not fully controlled, we need to continue antiepileptic drugs (AEDs) for minimum 3 years seizure free period.

1 Ideally pregnancy should be planned after seizures are controlled and one is off AEDs. Sometimes it may not be possible as in your case.

2 Can the epilepsy attack happen during pregnancy? Yes, it can occur but chances are less if one is on AEDs

3 Can it have adverse effect on pregnancy and baby? Yes. It has not been studied extensively in human. It carries a small risk of adverse effects on the fetus and pregnancy

4. You will have to take a calculated risk after consulting your neurologist and obstetrician. If you decide for pregnancy regular antenatal care is must.

All the best.

Pratap