Topic overview

Start with the big picture

The lesson follows care across preconception, pregnancy, delivery, and postpartum. It emphasizes aiming for seizure freedom with monotherapy at the lowest effective dose before conception, reviewing medicine-related fetal risks, and providing folic acid supplementation. It also introduces how pregnancy may alter lamotrigine and levetiracetam clearance and why levels and doses may need follow-up. Other areas include prompt management of acute seizures, additional considerations with enzyme-inducing medicines, fetal anomaly screening, breastfeeding, and postpartum dose reduction. Counseling addresses adherence, teratogenicity, and avoiding abrupt medication changes. Together, these topics frame decisions around balancing seizure control with safety for both parent and baby.