Predictors of Poor Seizure Control in Women with Generalized Epilepsy Who Replace Valproate

Valproate (VPA) is an effective antiseizure medication for people with idiopathic generalized epilepsy (IGE). However, its use during pregnancy elevates the risk for major congenital malformations and adverse effects on fetal neurodevelopment. In a multicenter, retrospective study, investigators sought to identify (1) predictors of poor seizure control in women with IGE who replaced valproate with an alternative medication and (2) an effective therapeutic alternative in such circumstances. They collected follow-up 1- and 2-year data on seizure control, including recurrence of seizures in people previously seizure free or a more than 50% increase in seizure frequency, from 426 women seen at 16 centers who replaced valproate due to teratogeni…