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We could not agree more with the comment on our editorial1 submitted by Dr. Sethi. Drs. Tomson, Meador, and I are members of the International League Against Epilepsy (ILAE) Task Force on Women and Pregnancy. Our first goal has been education of healthcare providers across a variety of specialties and disciplines, especially because epilepsy care is often delivered by generalist MDs and non-MD providers in low- and middle-income countries in Asia and Africa. We have placed emphasis on the known different levels of risk between the antiseizure medicines and the importance of pregnancy planning, with optimization of the medicine and vitamin regimen before conception. Dr. Sethi's suggestion of also bringing it to the attention of healthcare policy makers and planners is an equally important endeavor. One approach could be to highlight that by restricting AED access to save money, the ultimate national costs in the loss of productivity in patients with epilepsy, and in supporting the healthcare and educational needs of children of women with epilepsy, are probably far greater. The ILAE is aware of this problem and is working to understand and solve this difficult dilemma.
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