Pregnancy in women who have epilepsy

Epilepsy is the most common neurologic disorder that requires continuous treatment during pregnancy, and antiepileptic drugs (AEDs) are one of the most frequent chronic teratogen exposures. Up to 10% of infants exposed to AEDs in utero will have features of the fetal anticonvulsant syndrome include minor anomalies, major congenital malformations, intrauterine growth retardation, cognitive dysfunction, microcephaly, and infant mortality. Seizure control is paramount, and most women who have epilepsy need to be maintained on an AED during pregnancy. Medications should be optimized by achieving AED monotherapy and beginning folic acid supplementation before conception. Careful planning and management of any pregnancy in a woman who has epilepsy is essential to minimize maternal and fetal risks.