Intrauterine Epileptic Seizures: Possible?

Intrauterine epileptic seizures have rarely been reported to date and are surely underdiagnosed, as the possibility is not taken into consideration.

We report on three of our cases and two successfully treated intrauterine cases. In all the three cases, the mothers experienced two different qualities of child movement beginning roughly in the 24th week of pregnancy. Fetus movement they felt to be normal and prolonged “hard” stereotype movements of a rhythmic character, which they had not discussed with their gynecologists.

The following postpartum diagnoses were made: (1) catastrophic infantile epilepsy in tuberous sclerosis, (2) epileptic encephalopathy of the neonate with evidence of SCN2A mutation, and (3) pyridoxine-dependent epilepsy. In subsequent pregnancies of (1) the child’s movements were always normal and not comparable with the child’s movements during the first pregnancy. In the family with the index child with pyridoxine-dependent epilepsy, there were four subsequent pregnancies with normal child’s movements, which the mother treated on her own initiative taking 100 mg of pyridoxine beginning in the 14th week of pregnancy; two further children in this family have a pyridoxine-dependent epilepsy.

In the literature to date, 14 pregnancies with intrauterine epileptic seizures of the fetus with findings similar to our pregnancy studies have been reported. Rhythmic stereotype child movements are indicative of intrauterine epileptic seizures. In the epileptologic anamnesis of early childhood encephalopathies, they should be recorded in the anamnesis as early onset of encephalopathy with unfavorable prognosis. In pyridoxine-dependent epilepsy, intrauterine epileptic seizures can be successfully treated with pyridoxine.