Epilepsy living in pregnancy

Overview

Epilepsy is a condition that causes repeated seizures—sudden bursts of electrical activity in the brain that can affect how you feel or act. For women with epilepsy who become pregnant, it is important to manage the condition carefully to keep both mother and baby safe.

Epilepsy affects about 1 in 100 people, and many women with epilepsy are of childbearing age. It is a common condition that can be managed during pregnancy.

This information is for women with epilepsy who are pregnant or planning to become pregnant. It also applies to those who may have epilepsy and are considering pregnancy.

Symptoms

Common symptoms

• Generalized seizures: affecting the whole brain, causing loss of consciousness and body jerking.
• Focal seizures: affecting only part of the brain, causing changes in sensation, movement, or awareness.
• Absence seizures: brief staring spells or loss of awareness.

Symptoms in children

• Seizures in children can look like staring, sudden falls, or muscle jerking.
• During pregnancy, the focus is on the mother’s symptoms, but epilepsy can begin at any age.

Symptoms in older adults

• In older adults, seizures may be less obvious, like confusion or memory lapses.
• Pregnancy is less common in older women, but the same seizure symptoms can occur if epilepsy is present.

Causes

Main causes

• Epilepsy often has no clear cause, but may result from brain injury, infection, stroke, or genetic factors.
• Hormonal changes during pregnancy can affect seizure control.
• Missing doses of epilepsy medicine or changes in sleep can trigger seizures.

Risk factors

• Not taking epilepsy medicine as prescribed.
• Lack of sleep or poor sleep quality.
• High stress or skipping meals.
• Alcohol or drug use during pregnancy (always avoid).

When to see a doctor

See a doctor urgently if:

• If you have any seizure during pregnancy, even a mild one.
• If you are thinking of becoming pregnant and have epilepsy – see your doctor before pregnancy.
• If you have severe side effects from your medicine.

Book a routine appointment if:

• Regular checkups with both your neurologist and obstetrician.
• Medication review at each visit.
• If you miss a dose of your epilepsy medicine.

Diagnosis

Epilepsy is typically diagnosed based on your seizure history, a description of what happens during seizures, and tests like an EEG (electroencephalogram) that records brain activity.

Tests that may be done

• Electroencephalogram (EEG) – records electrical activity in the brain.
• Blood tests – to check for other causes of seizures.
• Imaging tests like MRI – to look for brain abnormalities.

What to expect at your appointment

If you are pregnant and have epilepsy, your healthcare team will monitor you closely. You will have regular appointments with a neurologist and an obstetrician. They may adjust your medicine doses to keep seizures under control while protecting your baby.

Treatment

The goal of treatment during pregnancy is to prevent seizures while keeping risks to the baby as low as possible. This is done by continuing epilepsy medicine under close supervision, often with dose adjustments.

Self-care at home

• Take your epilepsy medicine exactly as prescribed – never stop it without talking to your doctor.
• Get enough sleep – aim for 7–9 hours each night.
• Manage stress with relaxation techniques like deep breathing.
• Avoid alcohol and recreational drugs.
• Keep a seizure diary to track any changes.

Medical treatments

Doctors may use anti-epileptic drugs (AEDs) to control seizures. During pregnancy, the dose may be increased or decreased based on blood levels and how the pregnancy affects your body. Your doctor will choose the safest medicine for you and your baby. Do not change or stop your medicine without medical advice.

When is surgery considered?

Surgery for epilepsy is rarely considered during pregnancy. It may be discussed after birth if seizures are not controlled with medicine.

Living with this condition

Living with epilepsy during pregnancy requires regular checkups and careful attention to your health. You may need to see your neurologist and obstetrician every 1–2 months, and have some extra monitoring of your baby.

Lifestyle tips

• Maintain a stable sleep schedule.
• Eat regular, balanced meals.
• Avoid triggers like flashing lights if you have photosensitive epilepsy.
• Tell your family, friends, and workplace about your condition and what to do in a seizure.

Diet and exercise

Eat a healthy diet rich in fruits, vegetables, whole grains, and lean protein. Take folic acid (400–800 micrograms daily) as recommended by your doctor. Moderate exercise like walking is safe and beneficial, but avoid activities that could be dangerous if a seizure occurs (e.g., swimming alone). Always consult your healthcare team before starting new exercise.

Mental health and emotional wellbeing

It is normal to feel anxious or worried about seizures and your baby’s health. Hormonal changes can also affect mood. Talk to your doctor if you feel depressed or overwhelmed – support is available.

Prevention

Epilepsy itself cannot be prevented, but you can reduce the chance of seizures during pregnancy by taking your medicine as prescribed, getting enough sleep, and avoiding known triggers.

Vaccines

Talk to your doctor about routine vaccinations during pregnancy. There is no specific vaccine to prevent epilepsy.

Screening programmes

Preconception counseling is recommended for all women with epilepsy who plan to become pregnant. This helps optimize your treatment and reduce risks.

Complications

If left untreated

• Increased risk of seizures during pregnancy.
• Higher chance of injury from seizures to both mother and baby.
• Possible preterm birth or low birth weight.
• Slightly increased risk of developmental delays in the baby.

Long-term outlook

The outlook is very positive. With proper medical care, most women with epilepsy have healthy pregnancies and healthy babies. Working closely with your healthcare team and following your treatment plan gives you the best chance for a safe and positive experience.

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