seizure in pregnancy

Overview

A seizure is a sudden burst of abnormal electrical activity in the brain. It can cause jerking, staring, confusion, or passing out. When a seizure happens during pregnancy, it is called a seizure in pregnancy. This can happen to women who already have epilepsy or as a first-time event. With proper medical care, many women who have seizures during pregnancy go on to have healthy babies.

Seizures during pregnancy are not very common. About 1 in 200 pregnant women has epilepsy, and some women may have a first seizure while pregnant. Another cause, called eclampsia, can also lead to seizures, but regular prenatal care helps catch warning signs early.

It affects pregnant women who already have a seizure disorder, and sometimes women who have never had a seizure before. It can also affect women who develop a condition called pre-eclampsia, which can lead to seizures if not treated.

Symptoms

Common symptoms

• Sudden jerking or shaking of the arms and legs
• Staring blankly and not responding
• Confusion or being unaware of your surroundings
• Losing consciousness or passing out
• Lip-smacking or repetitive movements
• A warning feeling before the seizure, like an unusual smell or a strange feeling in the stomach

Causes

Main causes

• Epilepsy — a condition where a person is prone to seizures
• Eclampsia — a serious condition of pregnancy that can cause seizures, usually after pre-eclampsia
• Brain problems — such as a tumor, stroke, or infection
• Sudden changes in epilepsy medicines during pregnancy
• Low blood sugar, low sodium, or other metabolic imbalances

Risk factors

• Having epilepsy before pregnancy
• Previous seizures during pregnancy
• Pre-eclampsia or high blood pressure in pregnancy
• Carrying more than one baby (twins or more)
• Not taking epilepsy medicines as prescribed
• Missing sleep or stopping medicines suddenly

When to see a doctor

See a doctor urgently if:

• If you have any seizure during pregnancy, call your local emergency number immediately.
• If you feel a warning seizure (aura), severe headache, or sudden blurry vision, get urgent care.
• If you have been diagnosed with pre-eclampsia and notice signs of a seizure, seek emergency help.

Book a routine appointment if:

• Before pregnancy, talk with your doctor to review your seizure medicines and plan for a healthy pregnancy.
• At the start of pregnancy, make an appointment to see your pregnancy care provider, even if you feel fine.
• Attend all prenatal check-ups so your blood pressure and baby's growth are monitored.

Diagnosis

Doctors diagnose seizures in pregnancy by asking what happened, checking blood pressure and urine, and sometimes doing brain tests. They will also check the baby's heart rate and movements. If eclampsia is suspected, they will monitor you in the hospital.

Tests that may be done

• Blood pressure checks
• Urine test to look for protein
• Blood tests to check organ function and electrolytes
• Electroencephalogram (EEG) to measure brain activity
• Imaging of the head, such as MRI or CT scan, if needed

What to expect at your appointment

If you have a seizure in pregnancy, you will likely stay in the hospital for close monitoring. Doctors will watch you and your baby. They may adjust your medicines or give other treatments to prevent more seizures. You will have regular check-ups for the rest of your pregnancy.

Treatment

Treatment focuses on stopping the seizure and preventing more seizures, while keeping mother and baby safe. The exact plan depends on the cause, how far along the pregnancy is, and the woman's health. It is important to work with a healthcare team that includes an obstetrician and sometimes a neurologist.

Self-care at home

• Take all prescribed medicines exactly as directed — do not stop or change them on your own
• Get enough sleep and rest, as tiredness can trigger seizures
• Avoid alcohol and recreational drugs
• Keep all prenatal appointments and blood pressure checks
• Tell your healthcare provider about any new symptoms right away

Medical treatments

Doctors may use medications to control or prevent seizures. These are chosen carefully to be as safe as possible for the baby. For eclampsia, doctors may give medicine to lower blood pressure and prevent seizures, often through an IV in the hospital. You may need to stay in the hospital for observation and treatment.

When is surgery considered?

Surgery is rarely needed for seizures during pregnancy. It might only be considered if imaging shows a specific brain problem, such as a tumor or blood clot, that needs to be treated. This would be discussed with a specialist team.

Living with this condition

Take care of your whole body — rest when you need to, keep up with prenatal visits, and talk openly with your healthcare team. Carry a mobile phone and let someone know where you are. You can also wear a medical alert bracelet that says you have had seizures.

Lifestyle tips

• Sleep at least 7 to 8 hours each night
• Avoid skipping meals and drink enough water
• Stay away from flashing lights if you know they are a trigger for you
• Avoid driving unless you have been cleared by a doctor
• Set up a safe home environment — for example, shower instead of bath, and avoid standing on chairs

Diet and exercise

Eat a balanced diet with regular meals to keep blood sugar steady. Gentle exercise like walking or swimming is usually safe, but check with your doctor first. Some special diets for epilepsy may be helpful, but never change your diet without professional advice.

Mental health and emotional wellbeing

Pregnancy and seizures can bring up feelings of stress, fear, and worry. It is okay to ask for support. Talk to your healthcare provider if you feel sad, overwhelmed, or not yourself. If you ever feel like harming yourself or have thoughts of crisis, call your local emergency number or a mental health helpline right away — you deserve help.

Prevention

Many seizures during pregnancy can be prevented. For women with epilepsy, taking the right medicine and keeping stress and sleep under control helps a lot. For eclampsia, regular prenatal visits to check blood pressure and urine can catch problems early and prevent seizures from happening.

Vaccines

There is no vaccine that specifically prevents seizures. But getting recommended vaccines like flu and whooping cough during pregnancy is important. They protect you and your baby from infections that could make your brain or body stressed and possibly trigger a seizure.

Screening programmes

Prenatal screening for pre-eclampsia is part of every check-up. Your healthcare provider will measure your blood pressure and test your urine for protein. If signs appear, early treatment can prevent seizures from developing.

Complications

If left untreated

• Injury to the mother from falls or accidents during a seizure
• Less oxygen reaching the baby during a seizure, which can be harmful
• Premature birth or low birth weight
• Placental abruption (early separation of the placenta)
• Higher risk of another seizure if the cause is not treated

Long-term outlook

With prompt and ongoing medical care, the outlook is generally positive. Many women with seizures in pregnancy go on to deliver healthy babies and manage their condition well. Your healthcare team is there to support you every step of the way. You do not have to face this alone.

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