Preconception care for patients with epilepsy: a commentary based on a case presentation

Abstract

Preconception care (PCC) in epilepsy supports informed decision-making and improves maternal and child outcomes. Key information provided during PCC includes the impact of epilepsy on pregnancy, genetic considerations, and the relationship between antiseizure medicines and pregnancy or breastfeeding. This article reviews PCC in epilepsy and presents a case where information provision led to a second pregnancy. The case involves a teenage female with focal epilepsy, diagnosed at age 12, with irregular follow-ups. In October of year X, she revisited our clinic due to poor seizure control, and zonisamide was continued. However, she discontinued follow-ups again and reported pregnancy and AED discontinuation in June of year X+1. Comprehensive counseling was provided to her and her parents regarding epilepsy and pregnancy, leading to agreement on resuming medication. She delivered her first child in January of year X+2, remained stable thereafter, reported a second pregnancy in November, and delivered in July of year X+3. In this case, information provision alleviated anxiety towards a second pregnancy and improved adherence to epilepsy treatment.