Pregnant patients presenting with their first seizure, should essentially be managed in the same way as any other adult patient (i.e. Is the source of the seizure due to a reversible systemic condition, and if not, is the patient at risk for recurrent unprovoked seizures; specialist follow-up arrangement).
Additional pregnancy-related conditions that can be associated with seizure, such as eclampsia and cerebral venous thrombosis, should be considered.
While the safety of all anti-epileptic drugs in pregnancy is questionable, the use of valproate (Depakote) should definitely be avoided, given its compelling association with fetal malformations.
