JLE

Epileptic Disorders

MENU

Deep brain stimulation (DBS) of anterior nucleus thalami (ANT) in female epilepsy patients during pregnancy and delivery: experience from two cases Volume 23, issue 6, December 2021

TEST YOURSELF

(1) Are there reported cases of pregnancy under continued DBS therapy?

 

(2) Can ANT-DBS continuation be recommended during pregnancy?

 

(3) Does ANT-DBS therapy prevent female patients from becoming pregnant?

 

 

 

 

 

See answers

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Answers

 (1) To date, there are 22 reported cases of pregnancy under continued DBS including our two pregnancies under continued ANT-DBS in this case vignette with promising results.

 

(2) More evidence, in addition to the two cases we describe, is needed for a general recommendation. However, the information provided in this case vignette may be useful for ANT-DBS counselling and handling of female epilepsy patients who want, or potentially want to have children, as well as during pregnancy and delivery.

 

(3) There are no known potential ANT or non-ANT DBS-related risks for pregnancy or fertility. However, as for ANT-DBS, pulsatile stimulation of the ANT may theoretically result in potential problems regarding fertility and pregnancy because both depend on complex hormonal changes in the hypothalamic-pituitary-ovarian axis, and the mamillary bodies of the hypothalamus are part of the Papez circuit stimulated by ANT-DBS.

ANT-DBS in fact did not prevent our two patients from becoming pregnant after only a few monthly cycles following discontinuation of contraception, however, clearly, further evidence is needed to support this case vignette.

 

 

 

 

 

 

 

 

 Back to questions