Epilepsy in pregnancy: Pharmacodynamics and pharmacokinetics

After headache, epilepsy is the second most common neurological disorder encountered in pregnancy. Epilepsy is one of the most common chronic neurological conditions in the world, with an estimated 50 million people affected worldwide. The majority of pregnant women with epilepsy have an uneventful pregnancy, labour and birth. Many pregnant women with epilepsy have well-controlled seizure activity owing to antiepileptic drugs. The use of antiepileptic drugs during pregnancy is challenging because of the need to maintain the balance between the benefits for the woman in seizure control and the risks to the fetus from the teratogenic effects of antiepileptic drugs. Sodium valproate and lamotrigine are currently prescribed for seizure control in pregnancy; midwives should be aware of the effects of these antiepileptic medications on the pregnant woman and her fetus.