الفهرس 
Acknowledgement
Generalized epilepsiesOnly 14 pages are availabe for public view
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Abstract
Even healthy parents have 2% to 3% risk of having a child with a malformation, the best we can do is practice risk reduction.
- The management of pregnant women with epilepsy presents unique challenges. Confirmation of the diagnosis of epilepsy and verification of the most appropriate AED for the individual are the starting points. With effective patient education and careful and consistent management—which includes coordinated treatment planning by both neurologist and obstetrician—these patients have successful pregnancies and healthy offspring.
- Monitoring free drug levels both before and during pregnancy will permit accurate assessment of concentrations in a situation where plasma protein binding is in flux. Dose adjustment, should be made on a clinical basis.
- Keep the dosage as low as possible during conception and organogenesis, but will often raise it during the third trimester to reduce the risk of seizures during labor.
- Anatomic ultrasonography at early weeks to identify the vast majority of structural defects. Monitoring of maternal serum alpha fetoprotein.
- In general, risks can be minimized by the preconceptual use of multivitamins(including vitamin B6) with folic acid, AEDs in monotherapy at the lowest effective dose, and by preventing maternal seizures.
- Folic acid (five milligrams per day) should be taken for three months prior to conception and during the first trimester to prevent folic acid deficiency induced malformations (i.e., neural tube defects).
- Performance of multicenters prospective and population –based studies of pregnancy outcome according to standardized study protocol and standardized study procedures.
- We recommended the use of the AEDs either old or new in the effective therapeutic dose to control epilepsy in the pregnant women.
- The new AEDs are better than the old ones because they are free from major congenital malformation as neural tube defects.