25th June 2023

A 27-year-old woman has come into epilepsy clinic for prenatal counselling as she wants to start a family

A 27-year-old woman has come into epilepsy clinic for prenatal counselling as she wants to start a family. She has never been pregnant before. She has tonic-clonic seizures and is currently on sodium valproate for this. She has had 5 seizures in her lifetime. She has been reading about sodium valproate in pregnancy and wants to stop taking it to avoid harm to the baby.

In addition to high dose folic acid supplementation, what is the most appropriate next step in management for this patient?