Many women with epilepsy worry that taking seizure medicine during pregnancy will cause cerebral palsy in their child. Current research does not show that antiseizure medicines directly cause cerebral palsy in most cases, but some medicines are linked to other problems such as birth defects and learning difficulties, and a few studies raise questions that are still being studied.
What is cerebral palsy
Cerebral palsy is a long term condition that affects movement and posture due to damage or abnormal development of the baby’s brain, usually before birth or in early infancy. It is not a single disease but a group of disorders. Children with cerebral palsy often have other challenges such as learning difficulties, feeding problems or epilepsy, but the core problem is motor impairment caused by early brain injury or disturbance in brain development.https://pmc.ncbi.nlm.nih.gov/articles/PMC12748543/
Common causes and risk factors for cerebral palsy
Most cases of cerebral palsy are linked to factors that affect the baby’s brain during pregnancy, birth or the newborn period. Research has identified several important risk factors:
Preterm birth
Babies born before 37 weeks, especially very early preterm, have a much higher risk of cerebral palsy because their brains are still very fragile. Problems like bleeding in the brain, infection, or lack of oxygen in preterm infants can lead to permanent injury.https://pmc.ncbi.nlm.nih.gov/articles/PMC12767667/
Complications around birth
Events such as lack of oxygen during labor, severe birth asphyxia, or serious infections in the newborn period can damage the brain and increase the chance of cerebral palsy.https://pmc.ncbi.nlm.nih.gov/articles/PMC12748543/
Maternal and neonatal problems
Studies have linked factors like neonatal seizures, hypoxic ischemic encephalopathy (a type of brain injury caused by lack of oxygen and blood flow), severe jaundice, and not crying at birth with a higher risk of cerebral palsy.https://pmc.ncbi.nlm.nih.gov/articles/PMC12748543/
In many children, no single clear cause is found. Often several risk factors combine, for example preterm birth together with infection or breathing problems.
Epilepsy in pregnancy and why treatment matters
Epilepsy itself can affect pregnancy and the baby if seizures are not controlled. Generalized tonic clonic seizures can reduce the oxygen the baby receives for short periods, increase the risk of injury from falls or accidents, and in rare cases be life threatening for both mother and baby.https://plexusnc.com/epilepsy-and-pregnancy-separating-myths-from-facts/
Uncontrolled seizures may also increase the chance of preterm birth or other complications, and preterm birth itself is a strong risk factor for cerebral palsy.https://pmc.ncbi.nlm.nih.gov/articles/PMC12767667/ For this reason, most experts strongly advise that women with epilepsy continue antiseizure medication during pregnancy, with careful choice of drug and dose.
What is known about antiseizure medicines and birth outcomes
Modern studies of prenatal exposure to antiseizure medicines (also called anti epileptic drugs or antiseizure medications, ASMs) focus mainly on:
• major congenital malformations such as heart defects, spina bifida or cleft palate
• effects on later learning, IQ and behavior
• overall neurodevelopmental outcomes
A large study published in Neurology found that prenatal exposure to valproic acid clearly increases the risk of major birth defects compared with other antiseizure medicines, while most other commonly used medicines, such as lamotrigine and levetiracetam, did not show the same level of risk for structural malformations.https://www.neurology.org/doi/10.1212/WNL.0000000000214350 Other research has shown that valproic acid exposure is linked with lower IQ and higher rates of developmental and behavioral problems in childhood.
For several newer drugs, data are still limited, but in general the pattern is that:
• high dose valproic acid is one of the riskiest drugs for structural and cognitive outcomes
• some older medicines like phenobarbital and topiramate may also carry increased risks
• lamotrigine and levetiracetam are often considered safer choices, with lower rates of major malformations in current data setshttps://www.neurology.org/doi/10.1212/WNL.0000000000214350
These findings guide neurologists and obstetricians in recommending specific medicines before and during pregnancy.
Does maternal epilepsy medication cause cerebral palsy
When researchers look specifically at cerebral palsy, several points are important:
1. Cerebral palsy usually comes from early brain injury or disturbed brain development. Antiseizure medicines act on brain chemistry, but they are not known to directly cause the types of brain lesions typically seen in cerebral palsy, such as large areas of white matter damage from prematurity, major strokes, or prolonged severe oxygen lack.https://pmc.ncbi.nlm.nih.gov/articles/PMC12748543/
2. Large antiseizure medicine pregnancy registries and cohort studies focus heavily on malformations and cognitive outcomes. So far they have not shown a strong, consistent signal that these drugs, as a group, are a common direct cause of cerebral palsy. The stronger and more consistent associations are with birth defects and developmental issues rather than with cerebral palsy itself. { lazyloadBackgroundObserver.observe( lazyloadBackground ); } ); }; const events = [ 'DOMContentLoaded', 'elementor/lazyload/observe', ]; events.forEach( ( event ) => { document.addEventListener( event, lazyloadRunObserver ); } );