June 15, 2020

New-Onset Epilepsy in Women with First-Time Seizures During Pregnancy

Abstract, published in Seizure

Introduction: In women with epilepsy, seizure frequency and severity can be affected during pregnancy by factors such as changes in anti-seizure drug, metabolism, changes in hormone levels, and medication compliance. Some women with epilepsy experience seizure worsening during pregnancy, while others have an improvement. Most epileptic seizures during pregnancy occur in women with pre-existing epilepsy, but some women can develop new-onset seizure-like episodes during pregnancy, the latter of which poses a diagnostic and therapeutic challenge for the physician.

Methods: To determine the frequency of new-onset seizures during pregnancy and the clinical course of those with new seizures, we performed a retrospective study of all women with concomitant diagnoses of pregnancy and seizures at the Johns Hopkins Medical Institutions over a five-year period.

Results: Of the 41,869 women who received pregnancy care at Johns Hopkins Medical Institutions, eighty-four women had at least one seizure-like event. Of these, eleven had no prior history of seizures and five were found to have first-time unprovoked epileptic seizures, indicated by epileptiform abnormalities on EEG. All women delivered at term with no major complications. Four of these women continued to have epileptic seizures after delivery.

Conclusions: Although new onset seizures during pregnancy were rare, most women with first-time epileptic seizures during pregnancy continued to suffer from epileptic seizures after pregnancy.

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