Patty McGoldrick: Epilepsy is often a little more difficult and challenging to control in pregnancy because the hormones are changing, and the levels of the medication may need to be adjusted. There is a big risk to the fetus if you're having seizures during pregnancy, so it's very important that the medication and the seizures be well controlled during that time.
Dr. Steve Wolf: We really recommend that you discuss with your doctors and your nurse practitioners and neurologists, if you are planning on getting pregnant, discuss it beforehand, so they can look at what medications you're on, decide if those medications are safe for you to be pregnant with. Also, there are certain vitamins that we recommend that you be taking before you get pregnant, such as folic acid.
Patty: Right. So well before you get pregnant, you should be having this conversation. This includes teenage girls, whether or not they're thinking about getting pregnant are of child-bearing age. You need to supplement folic acid. We usually check a level of the medication in your blood before you get pregnant, and then we often check it every month to make sure that you're still maintaining an adequate level. There are certain medications that are not safe during pregnancy, and yet there are alternatives that are quite safe.
Dr. Wolf: So you need to have this conversation even when you're a teenager or early on with the people taking care of you. Is this a safe medication to get pregnant on? How would I plan for it? What level should be done?
Patty: Have the conversation early. Have a plan set in place. There are certain medications that can cause damage to the fetus, so you don't want to be on them, and you want to keep very, very good control of your seizures during your pregnancy.