Management of women with epilepsy during pregnancy

Epilepsy is one of the most common neurological problems in pregnancy. Approximately one in 200 pregnancies is to a woman with epilepsy taking antiepileptic drugs (AEDs). For the majority of women, pregnancy proceeds without any apparent difficulties. However, there is evidence of increased risks for both mother and child. Therapeutic decisions need to take this balance of risks into account. The evidence for the risks and their limitations are reviewed in this article. The main management and counselling issues are also summarised. The aim of treatment is to avoid convulsive seizures that are harmful for both mother and child while minimising risks from the treatment of epilepsy.