Anticonvulsants and Pregnancy Generalized seizure The patients with epilepsy and the moyamoya patients with seizure might be discriminated. In moyamoya disease, seizure occurs due to either brain damage caused by infarction or hemorrhage or ischemia without brain damage by moyamoya disease. In the latter case, anticonvulsants might be unnecessary after successful revasculization by bypass surgery. Effects of anticonvulsants on fetus It is well known that anticonvulsants increase the risk of congenital anomalies, i.e., 4-6% increase above the general incidence. Among the congenital anomalies, cleft lip and cleft palate are most common, which are followed by septal defect of the heart. Valproic acid has 1-2% risk of myelomeningocele. Multiple anticonvulsants further increase the chance of congenital anomalies. These adverse effects are toward the female patients. For male patients, it is said that anticonvulsants have no potential effect on the fetus. The concentration of the anticonvulsants decreases in the course of pregnancy. It becomes least just before delivery. Anticonvulsants may induce bleeding tendency in newborn, but vitamin K administration at the end of pregnancy may prevent it. Finally, it is a fact that many women prescribed with anticonvulsants deliver normal, healthy babies. Sexual intercourse has no adverse effects on the epileptic seizure.