Introduction: Treatment of the epileptic patient during pregnancy poses a major clinical dilemma. For one thing the patient has to be kept free of seizures, but she also should be kept on monotherapy at the lowest possible dose, due to the effect such medication may have on the unborn child.
Development: There is a syndrome related to intra uterine exposure to the classical antiepileptic drugs, but which is not associated with any particular drug. However, the effect of the new antiepileptic drugs on unborn children is still unknown. To date, no specific pattern of malformations has been described in relation to any of these drugs. Lamotrigine is the one with which there is most clinical experience. Although there are still not enough cases studied to permit definite conclusions to be drawn, at the moment the incidence of congenital anomalies is the same as in the general population.
Conclusions: The new anti-epileptic drugs have a major therapeutic advantage, not only in the management of epilepsy in different clinical situations, but also in the good results observed when using lamotrigine in patients of fertile age.