Gjerde I O, Strandjord R E, Ulstein M
Department of Neurology, Haukeland Hospital, Bergen, Norway.
Acta Neurol Scand. 1988 Sep;78(3):198-205. doi: 10.1111/j.1600-0404.1988.tb03646.x.
We have compared frequency and severity of epileptic seizures during pregnancy with the 9 months prior to pregnancy in 66 patients with a total of 78 pregnancies. Data on total number of seizures and major seizures are analysed separately. No statistically significant differences between frequency before and during pregnancy were found. Cases with seizures before pregnancy tended to have seizures during pregnancy, but there was no association between occurrence of seizures prior to pregnancy and increased frequency during pregnancy. There was no evidence that seizures became more severe during pregnancy. No relationship was found between type of epilepsy and change in seizure frequency during pregnancy. The data suggest that our therapeutic interventions may have influenced seizure frequency in at most a minority of cases. Serum concentrations of the anti-epileptic drugs were monitored regularly during pregnancy. Only data on patients on constant drug dosages and, therefore, presumedly with the mildest seizure disorders were analysed. In the majority of cases there was a decrease in drug levels during pregnancy. Most cases tolerated this decrease without an increase in seizure frequency. On the other hand, most cases with increased frequency also had decreased drug levels.
我们比较了66例患者共78次妊娠期间癫痫发作的频率和严重程度与妊娠前9个月的情况。分别分析了癫痫发作总数和主要发作的数据。未发现妊娠前和妊娠期间癫痫发作频率有统计学上的显著差异。妊娠前有癫痫发作的病例在妊娠期间往往也会发作，但妊娠前癫痫发作的发生与妊娠期间发作频率增加之间没有关联。没有证据表明癫痫发作在妊娠期间会变得更严重。未发现癫痫类型与妊娠期间癫痫发作频率变化之间存在关系。数据表明，我们的治疗干预措施可能至多只对少数病例的癫痫发作频率产生了影响。妊娠期间定期监测抗癫痫药物的血清浓度。仅分析了使用固定药物剂量、因此推测癫痫发作障碍最轻的患者的数据。在大多数情况下，妊娠期间药物水平会下降。大多数病例耐受了这种下降，癫痫发作频率并未增加。另一方面，大多数发作频率增加的病例药物水平也下降了。
