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Women with Epilypsy (WWE) who want to have a child are a highly relevant subset of epilepsy patients. The treating epileptologist must define the epilepsy syndrome and select the appropriate Anti-Seizure Medication (ASM) while keeping in mind the main goal of seizure freedom, teratogenic risks, changes in drug metabolism during and after pregnancy, and the need for up-titration during and after pregnancy. This review also covers folic acid and vitamin K supplements, as well as breastfeeding. Teratogenic potential is lowest for lamotrigine and levetiracetam. Oxcarbazepine has a favourable teteratogenic risk profile, whereas topiramate has an unfavorable profile. Valproate requires special attention. It is most effective in generalized seizures, but it should be avoided as much as possible due to teratogenic effects and a negative impact on neuropsychological development.
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