All the following are advised in an epileptic woman preconceptionally except
Compared with unaffected women, those with a seizure disorder carry an undisputed augmented risk of having neonates with structural anomalies.Ideally, seizure control is optimized preconceptionallyTreatment goals attempt to achieve seizure control with monotherapy and with medications considered less teratogenic.The American Academy of Neurology recommends consideration of antiseizure medication discontinuation before pregnancy in suitable candidates. These include women who satisfy the following criteria: Have been seizure-free for 2 to 5 years, Display a single seizure type, Have a normal neurological examination and normal intelligence, and Show electroencephalogram results that have normalized with treatment.Epileptic women should be advised to daily take a 4-mg folic acid supplement. Women should be informed that the risk of congenital abnormalities in the fetus is dependent on the type, number and dose of Antiepileptic drugsValproic acid, in paicular, is avoided if possible, as this medication has consistently been associated with a greater risk for major congenital malformations than other antiepileptic drugs.Ref: William's obstetrics; 25th edition; Chapter 8; Preconceptional care
Attempt to achieve seizure control with monotherapy
Supplement folic acid with a dose of 1mg/day
Medication withdrawal is considered if a woman is seizure free for 2 years or more
Risk of congenital abnormalities in the fetus is dependent on the type, number and dose of Antiepileptic drugs
General obstetrics