ABSTRACT
withdrawal, whether undertaken after consultation or independently by the patient, should be sought. Furthermore, a careful history concerning minor seizures is needed. Women in whom the epilepsy is supposedly controlled are sometimes referred for consideration of withdrawal, but a more detailed history may reveal that they are experiencing infrequent auras, partial seizures, absences or myoclonus. Whilst these may be mild and need not necessarily pose a risk during pregnancy, they indicate that the epilepsy is active and that withdrawal of AEDs is unlikely to be appropriate where there is a previous history of more severe seizures. However, women who have only ever had mild seizures (myoclonus, brief absences, auras) with no history of GTCS or other more severe seizures may wish to come off medication before conception. This is reasonable so long as the woman is aware that while the risk of GTCS or more severe seizures may be low in her case, the occurrence of such seizures cannot be excluded. This possibility and its potential consequences would need to be discussed.
