Rischi e benefici della terapia con antiepilettici

Antiepileptic therapies can give rise to toxic problems. AED toxicity can be classified into idiosyncratic reactions, dose-dependent side effects, dose-independent side-effects. Furthermore adverse effects during pregnancy have to be taken into account. The AA reviewed the indications of AED and special situations where risks linked with an antiepileptic therapy might be more troublesome than rare epileptic seizures

Worsening in seizure frequency and severity in relation to folic acid administration

We report a case of increase in seizure frequency and severity in a 26-year-old woman receiving folic acid at a dosage of 0.8 mg/day. She had symptomatic partial epilepsy with simple and complex seizures treated with carbamazepine. She was planning pregnancy and we prescribed folic acid for prevention of neural-tube defects. In the next few days she had a generalized tonic-clonic seizure for the first time and a significant increase in seizure frequency. Because of the temporal relation between the seizure worsening and the administration of folic acid, we hypothesize a role of folic acid in provoking seizures, as has been reported in the literature