MANAGEMENT OF ABSENCE EPILEPSY: PRE-CONEPTION TO POST-PARTUM: A CLINICAL CASE REPORT

Abstract

Patient Presentation & History:
A 28-year-old female with a long-standing history of Childhood
Absence Epilepsy (CAE) presented for obstetric consultation.
While many cases of CAE resolve in adolescence, her condition
persisted into adulthood, characterized by brief (5–10 second)
episodes of impaired consciousness and staring spells.
Pre-Pregnancy Counselling:
Strategic planning was initiated six months prior to intended
conception to optimize maternal seizure control and minimize
fetal risk.
Pharmacological Transition: The patient was successfully
transitioned from Valproate to Ethosuximide. This transition was
managed over a 16-week period with serial EEG monitoring to
ensure no breakthrough seizures occurred.
Folic Acid Supplementation: In accordance with high-risk
epilepsy guidelines, the patient commenced 5 mg of Folic Acid
daily to mitigate the risk of major congenital malformations.
Lifestyle Optimization: Counseling focused on the “Seizure
Threshold” emphasizing regular sleep cycles and the avoidance of
known triggers like hyperventilation.