A 28-year-old woman with focal epilepsy has MRI evidence of left hippocampal sclerosis. She is planning pregnancy. Which antiepileptic is the preferred first-line option?
- A Valproate
- B Carbamazepine ✓
- C Phenytoin
- D Topiramate
Correct answer: B. Carbamazepine
Explanation
Carbamazepine is first-line for focal-onset epilepsy, including temporal lobe epilepsy with hippocampal sclerosis. Valproate is effective but is strictly avoided in women of childbearing age due to high teratogenicity (neural tube defects) and neurodevelopmental risks. Phenytoin and topiramate are alternatives but are not preferred first-line; topiramate also has teratogenic concerns.
Reference: Park's Textbook of Preventive and Social Medicine / ILAE guidelines
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.