Focal Epilepsy in Pregnancy with Underlying Antiepileptic Drug Allergy: A Case Report
Abstract
Background: The first-line antiepileptic drugs (AED) approved for focal epilepsy are levetiracetam, carbamazepine, phenytoin, and zonisamide. Uncontrolled seizures can be caused by non-adherence, inadequate treatment, drug tolerance, or adverse drug reactions. In a resource-limited setting, a patient can run out of treatment options if having an AED allergy and is pregnant. Case presentation: A 24-year-old woman with temporal lobe epilepsy was admitted to the hospital due to a breakthrough seizure. Because of her allergy to carbamazepine, with contraindication of sodium valproate in pregnancy and women of childbearing age, clobazam was added to levetiracetam as her treatment regime for focal epilepsy. The patient has reduced seizure frequency since the commencement of clobazam treatment. Conclusion: Clobazam is feasible as an add-on treatment option for focal epilepsy in childbearing-age women with AED allergies. Future studies are needed to establish the safety and dosing adjustment of clobazam in pregnant women.