妊娠可能年齢の女性におけるてんかん・痙攣治療の留意点

抄録

Approximately 90% of babies of women with epilepsy are reported to be normal, however, women with epilepsy have a 10–fold risk of death during delivery hospitalization. Upon commencement of therapy with antiepileptic medication in women of childbearing age, patients and their family should be advised whether they can practically carry out pregnancy and delivery, considering seizure severity, viability, and family cooperation. In adjusting ‘minimum maintenance dose’ for pregnancy, while generalized tonic–clonic seizures should be suppressed in order not to cause critical events as hypoxemia, acidosis, abortion, etc., milder seizures are permissible. Full consideration is needed of social life, driving, and business description. Dose of antiepileptic drugs should be in ‘minimum maintenance dose’ therapy with low risk of teratogenicity. Patients and their family members should be cautioned upon possible risk of developing severer seizures during dose reduction. New–onset epileptic seizures, or epileptic seizures whose types are different from habitual ones, various etiologies causing to acute symptomatic should be evaluated.