Abstracts

Rationale: Risks of seizure relapse is typically low in patients with epilepsy who are seizure free for more than 2 years. However, seizure relapses occasionally occur after giving birth without anti-epileptic drug (AED) reduction in epileptic women who were seizure free for more than 2 years. It is possible that this relapse is related to alterations in hormone levels or life-style with child bearing, however, little is currently known about this phenomenon. We retrospectively investigated seizure relapse in epilepsy patients after child-bearing. Methods: We examined women with epilepsy who gave birth after being seizure free for at least the 2 years previous. Individuals were followed for at least one year post-birth. Patients were sorted to 2 groups. Group 1 consisted of individuals that were seizure free for more than 5 years before child-bearing, and group 2 consisted of individuals that were seizure free for 2 ~ 5 years before child-bearing. Results: 49 patients (mothers) and 67 children (34 girls, 33 boys) were examined. Each patient had between 1 and 3 children. The mean age was 38.8 years, and the mean duration of follow up examination of each child and patients was 7.8 years. The mean age of onset of epilepsy was 13 years (10 months ~ 30 years-old). In group 1 (patients were seizure free for 5 years before child bearing), there were 49 children. In group 2 (patients were seizure free for 2 ~ 5 years before child-bearing), there were 18 children. 22 patients were diagnosed idiomatic generalized epilepsy (IGE), 23 were localization related epilepsy (LRE), 1 was MELAS, and 3 were unclassified. A total 17 of 67 (26%) patients had seizure relapses after delivery during following up. 9 of 17 patients were relapsed within one year (4 days ~ 8 months) of child-bearing. In group 1, 10.1% (5 of 49) of deliveries resulted in seizure relapses within one year after delivery. 22.2 % (4 of 18) relapsed within one year in group 2. 5 of 23 (22%) patients with LRE, compared to 3 of 22 (14%) patients with IGE relapsed within one year of child-bearing. Age of onset was not associated with relapse within one year or after one year. The sex of the baby was not associated with relapse. 5 of 33 boys` mother (15%) and 4 of 34 girls` mother (12%) relapsed within one year after delivery. However after one year after delivery, 6 of 33 boys` mother (18%) relapsed compared to 2 of 34 girl`s mothers (6%). Conclusions: The risk of seizure relapse was not low in women with epilepsy after child-bearing. Even the patients were seizure free for more than 5 years before child-bearing, seizure relapse was observed in 10% of them within one year of child-bearing. And it was 22% patients who were seizure free for 2 ~ 5 years. Our results suggest that longer period or remission may decrease the risk of relapses after delivery. Seizures can have a negative impact on patients as well as their children. Physicians therefore should advise patients about these issues including life-style, and may need to regulate AED to avoid seizure relapses with child-birth.