epilepsy_flashcards
What advice should be given pre-conception for women with epilepsy?
The risk of uncontrolled epilepsy generally outweighs the risk of antiepileptic medications to the foetus.
How should antiepileptic medications be adjusted pre-conception?
Reduce to monotherapy where possible, use preferred AEDs (lamotrigine and carbamazepine), use the lowest effective dose, and avoid sodium valproate.
What are the preferred antiepileptic drugs (AEDs) during pregnancy?
Lamotrigine and carbamazepine.
Which antiepileptic drug is contraindicated during pregnancy due to the risk of neural tube defects?
Sodium valproate.
What dose of folic acid is recommended pre-conception and during early pregnancy for women with epilepsy?
High-dose folic acid 5mg OD from pre-conception until 12 weeks’ gestation.
What antenatal monitoring is recommended for women with epilepsy?
Serial growth scans every 4 weeks from 28-36 weeks’ gestation, no need to monitor AED levels routinely.
What postnatal advice should be given to women with epilepsy?
Encourage breastfeeding (unless taking barbiturates), provide information on safe handling of the neonate, restart contraception, and continue AEDs.
What should be done if the AED dose was increased during pregnancy?
Dose review should occur within 10 days of delivery to avoid toxicity.
