skip to main content

Valproate in women of childbearing potential — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

HardEpilepsyValproate in women of childbearing potentialSCE Neurology

A 24-year-old woman with idiopathic generalised epilepsy is seizure-free on sodium valproate 1 g daily. She attends for pre-conception counselling and has no previous trials of alternative antiseizure medication. She understands the relapse risk but wishes to conceive within the next year. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Refer for specialist review to switch before conception

Refer for specialist review to switch before conception is the best answer. Valproate is strongly teratogenic and should be avoided in women who can become pregnant unless no suitable alternative exists; planned specialist transition before conception is best. Folic acid does not remove valproate risk; abrupt cessation risks seizures; carbamazepine may worsen generalised epilepsies; waiting until pregnancy is confirmed misses the highest-risk period. Clinical pearl: Pre-conception epilepsy care is a medication-safety intervention, not just a counselling exercise.

Reference: NICE NG217; MHRA valproate pregnancy prevention programme; BNF