Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep 23;6(1):21.
doi: 10.1186/s42494-024-00166-3.

Hippocampal sclerosis in women with temporal lobe epilepsy: seizure and pregnancy outcomes

Yujie Chen #  1 , Nanya Hao #  1 , Weixi Xiong  1 , Hesheng Zhang  1 , Enhui Zhang  1 , Zhujing Ou  1 , Lei Chen  1 , Xintong Wu  2 , Dong Zhou  3
Affiliations

Hippocampal sclerosis in women with temporal lobe epilepsy: seizure and pregnancy outcomes

Yujie Chen et al. Acta Epileptol. .

Abstract

Background: Temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) is typically resistant to pharmacological interventions; however, achieving seizure freedom is possible through surgery. Our objective was to focus on the pregnancy and seizure outcomes during pregnancy of women with TLE-HS, and aim to identify predictors of seizure control.

Methods: The West China Registry of Pregnancy of Women with Epilepsy (WCPR_EPi) was a monocentric prospective cohort study of women with epilepsy (WWE). We screened women with TLE-HS in this database. Their clinical profile, anti-seizure medication (ASM) use, and pregnancy outcomes were extracted from the records of the registry (2010-2023).

Results: Out of 2320 WWE followed up, 47 pregnancies in women with TLE-HS were identified and analyzed. Seizure exacerbation occurred in 40.4% of pregnancies, and seizure freedom was present in 34.0% of these during pregnancy. Factors associated with seizure exacerbation during pregnancy was ASM non-adherence (odds ratio [OR] =7.00, 95% confidence interval [CI] 1.43-34.07, P=0.016). The surgery group showed a significantly higher seizure freedom rate (OR = 6.87, 95% CI 1.02-46.23, P=0.016) and lower rate of induced labor (0.0% vs 26.5%, P=0.047) compared to the medically-treated group alone. Caesarean section was chosen in 77.1% of cases due to seizure concerns, with comparable in epilepsy-related (n=20) and obstetric causes (n=24). No major congenital malformations were reported.

Conclusions: Surgical treatment before pregnancy appears to offer a higher chance of seizure freedom compared to medication alone. Most of women with TLE-HS can deliver healthy offspring regardless of suboptimal seizure control and unwarranted concerns.

Keywords: Anti-seizure medications; Epilepsy in women, Retrospective studies; Hippocampal sclerosis; Pregnancy outcomes; Seizure management; Temporal lobe epilepsy.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate : This study was approved by the ethics committee of Sichuan University (2014-09). Patients provided written consent for their anonymized medical data to be analyzed and published for research purposes. Consent for publication: Not applicable. Competing interests: Author Dong Zhou is the member of the Editorial Board for Acta Epileptologica, who was not involved in the journal’s review of or decisions related to this manuscript.

Figures

Fig. 1
Fig. 1
Trimester change in seizure frequency for two seizure types. Abbreviation:Tr: trimester; FBTCS: focal to bilateral tonic-clonic seizure; FIAS: focal impaired awareness seizure
Fig. 2
Fig. 2
Seizure control in each trimesters between WWE with and without ASMs change by seizure types. a The occurrence and numbers of FBTCS seizures are compared between the two groups (with or without ASMs change) in each trimester of WWE b The occurrence and numbers of FIAS seizures are compared between the two groups (with or without ASMs change) in each trimester of WWE. Abrrevations: Tr: trimester; FBTCS: focal to bilateral tonic-clonic seizure; FIAS: focal impaired awareness seizure. The number of seizures was expressed as mean and the comparisons between the two groups were performed using the Wilcoxon rank sum test, as the data were not normally distributed. χ2 test or Fisher's exact test was performed to compare the seizure-freedom rate. For number of seizures : *P < 0.05, **P < 0.01 and ***P < 0.001; For seizure frequency rate: #P < 0.05, ##P < 0.01
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Singh A, Trevick S. The Epidemiology of Global Epilepsy. Neurol Clin. 2016;34(4):837–47. - PubMed
    1. Razaz N, Tomson T, Wikström A-K, Cnattingius S. Association Between Pregnancy and Perinatal Outcomes Among Women With Epilepsy. JAMA Neurol. 2017;74(8):983. - PMC - PubMed
    1. Adab N. The longer term outcome of children born to mothers with epilepsy. J Neurol Neurosurg Psychiatry. 2004;75(11):1575–83. - PMC - PubMed
    1. Tomson T, Battino D, Bonizzoni E, Craig J, Lindhout D, Perucca E, et al. Comparative risk of major congenital malformations with eight different antiepileptic drugs: a prospective cohort study of the EURAP registry. Lancet Neurol. 2018;17(6):530–8. - PubMed
    1. Johannessen S, Ben-Menachem E. Management of focal-onset seizures: an update on drug treatment. Drugs. 2006;66(13):1701–25. - PubMed

LinkOut - more resources