Work

Electroceuticals for Motherhood: Utility of responsive neurostimulation and Proactive antiseizure medication management in two pregnancies

Year: 2025

Type: article

Abstract: • Responsive neurostimulation (RNS) enabled two successful pregnancies in DRE. • Case illustrates ASM dose adjustment and RNS optimization during pregnancy. • Highlights interplay of ASM clearance, seizure control, and maternal–fetal safety. • Demonstrates RNS as a non-pharmacologic option when resection is not feasible. • Stresses importance of early preconception counselling and multidisciplinary care. Females with drug-resistant epilepsy (DRE) face unique challenges in balancing seizure control with the teratogenic risks of anti-seizure medications (ASMs) during pregnancy. This case study highlights the use of responsive neurostimulation (RNS) as an electroneuromodulatory strategy to enable safer pregnancies by reducing ASM burden while maintaining seizure control. A 25-year-old woman with bilateral limbic epilepsy secondary to autoimmune encephalitis underwent RNS implantation targeting the hippocampi. Over a multi-year preconception planning period, RNS optimization allowed for tapering of high-risk ASMs and stabilization of seizure frequency. Across two pregnancies, neuromodulation enabled stable epilepsy control and reduced reliance on polytherapy, despite pharmacokinetic ASM variability. Both pregnancies resulted in healthy infants with no major congenital anomalies, despite episodes of breakthrough seizures. This case underscores the transformative potential of RNS in the reproductive care of women with DRE—not only by improving maternal safety but also by reducing fetal exposure to teratogenic drugs. As the first report to demonstrate how RNS can facilitate pregnancy planning with details on how ASM was minimized and complex therapeutic monitoring, this study sets the stage for integrating electroneuromodulation into preconception counselling and epilepsy management for women of childbearing age.

Source: Epilepsy & Behavior Reports

DOI: 10.1016/j.ebr.2025.100838

Authors: Aisha Abdulrazaq, Dorothee Kasteleijn, Thomas Henry, Sandipan Pati

Institutions: University of Minnesota, Sapienza University of Rome

Language: English

Topic: Epilepsy research and treatment

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,630