Status epilepticus in pregnancy

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Abstract
In the 2nd trimester of pregnancy in a 26 yr old woman, marked exacerbation of epileptic seizures occurred with somatomotor status epilepticus. The oral requirement of phenytoin varied, and up to 1200 mg/day were needed to maintain a therapeutic plasma concentration during the 2nd trimester. Intestinal malabsorption was a causal factor; 56% of the daily oral dose of phenytoin was found in the stool. Late in pregnancy and postpartum, therapeutic plasma concentrations of phenytoin were maintained with decreased daily oral doses. Intestinal absorption improved postpartum.