امرأة عمرها ٢٦ سنة عندها صرع معمم مضبوط على الفالبروات منذ ٥ سنوات، تزوجت حديثاً وتخطط للحمل خلال أشهر، ولا تأخذ حمض الفوليك. ما أهم معلومة؟

A 26-year-old woman with generalised epilepsy well controlled on valproate for 5 years recently married and plans pregnancy within months; she takes no folic acid. What is the most important information?

1. Stop it herself immediately once pregnant
2. Review before conceiving, as valproate harms the fetus
3. Continue the same drug and dose without review
4. Valproate is the safest antiepileptic drug in pregnancy

Answer: B) Review before conceiving, as valproate harms the fetus. Valproate raises the risk of neural tube defects and developmental disorders, so pre-conception review aims to switch if possible, with high-dose folic acid. Abrupt stopping is dangerous because of seizures.