Epilepsy and pregnancy--principles of therapy

Special aspects of antiepileptic therapy during pregnancy in epileptic women are described. A monotherapy should be preferred. Due to changes in the pharmacokinetics of antiepileptic drugs, plasma level checks must be performed every four weeks during early pregnancy. The possible teratogenetic effects of anticonvulsants and other factors tending to increase of malformation rate are discussed. An explanation is given for the use of prophylactic folic acid and Vitamin K treatment in connection with antiepileptic therapy. The benefits of counselling prior to pregnancy are discussed.