SEIZURE DISORDERS

A   25-year-old primigravida    is  19  weeks’  gestation.  She has a   10-year

history of  generalized seizures    poorly  controlled  requiring   hydantoin   and

valproic    acid.   A   triple  marker  screen  result  showed  an  elevated    maternal

serum   alpha   feto    protein.

The prevalence of seizure disorders in women of childbearing age is 0.5%. There
are classified as follows:

The effect of pregnancy on seizure disorder is as follows:

The effect of seizure disorder on pregnancy is that pregnancy complications
are minimal with appropriate prenatal care and compliance with anticonvulsant

Partial seizures    do  not involve both    hemispheres.    They    can be  simple  (no

loss    of  consciousness)  or  complex (consciousness  may be  impaired).

Generalized seizures    involve both    hemispheres.    They    can be  absence type

(duration   <20 s   [formerly   called  “petit  mal”])  or  tonic-clonic    (duration   up  to

several minutes [formerly   called  “grand  mal”]).

Seizures    unchanged.  Up  to  25% of  these   women   will    experience

deterioration   of  seizure control during  pregnancy,  with    75% seeing  no  change.

The more    severe  the disorder,   the more    likely  it  will    worsen.

Anticonvulsant  metabolism  increased.  Seizure medication  clearance   may be

enhanced    by  higher  hepatic microsomal  activity,   resulting   in  lower   blood

levels.