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Prepregnancy Counseling for People of Childbearing Potential with Epilepsy (Pi-CME)
Activity Details
Provided by the American Epilepsy Society
Release Date: May 5, 2021
Expiration Date: May 3, 2024
All individuals of childbearing potential (12-44 years old) with a diagnosis of epilepsy, excluding those patients who have been diagnosed with menopause or are surgically sterile, are at risk for bearing children with birth defects as a result of low folic acid. Female patients or caregivers should be counseled at least once a year about how epilepsy and its treatment may affect contraception OR pregnancy.

This counseling should include a discussion about:
  1. Folic acid supplementation
  2. Interactions between Antiseizure Medications (ASMs) and contraceptives
  3. Potential anti-seizure effect on pregnancy/breastfeeding
  4. How pregnancy can affect ASM levels
  5. Safe pregnancies

This is a self-directed, web-based activity designed to help you evaluate the delivery of care in your clinical setting. The activity is comprised of 3 stages:

  • Stage A - Perform chart reviews, evaluate and reflect on results of the chart audit, and self-identify areas for improvement.
  • Stage B - Based on results of Stage A, develop and implement a plan to optimize patient education on folic acid supplementation in women with epilepsy who are of childbearing age as defined by the existing AAN Epilepsy Quality Measure)/capacity and on antiepileptic medication(s).
  • Stage C – After implementing plan (minimum of 30 days), evaluate the impact of your plan and perform a second chart review for patients seen after your plan implementation
Learning Objective

Following participation in the activity, the learner should be able to:

  • Cite and discuss the evidence for folic acid supplementation in preventing birth defects, as well as improving cognition in children who were exposed in utero to antiseizure medications (ASM), in this subpopulation of people with epilepsy (PWE).
  • Recognize that counseling for individuals of childbearing potential with epilepsy, which includes how epilepsy treatments may affect contraception and pregnancy, is part of the 2017 AAN Epilepsy Quality Measures.
  • List strategies for counseling this subpopulation of PWE on pre-conceptional issues which includes discussions about:
    • The interactions between anti-seizure medications and contraceptives
    • How epilepsy may affect pregnancy
    • How pregnancy may affect ASM levels
    • Potential teratogenic effects of ASMs, and
    • Optimizing folic acid supplementation in this subpopulation of PWE inclusive of strategies for addressing barriers.
  • Describe the recommended approach to shared decision-making.
Target Audience
Epileptologists, neurologists, professionals in epilepsy care, nurse practitioners, general physicians, and other interested healthcare professionals
Credit Information


The American Epilepsy Society is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. 

Credit Designation

The American Epilepsy Society designates this enduring material activity for a maximum of 20 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

International Credits:  The American Medical Association has determined that non-US. licensed physicians who participate in this CME activity are eligible for AMA PRA Category 1 Credits™.

Physician Assistants:  AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credits™ from organizations accredited by ACCME or a recognized state medical society.  Physician assistants may receive a maximum of 20 hours of Category 1 credit for completing this program.

Instructions for Participation to Earn CME Credit

  • Read the needs statement, target audience, learning objectives, and planner/faculty disclosures.
  • Complete stages A, B and C online or printed out.
  • Complete the evaluation.

Maintenance of Certification

The American Board of Psychiatry and Neurology has reviewed the PI-CME activity "Prepregnancy Counseling for People of Childbearing Potential with Epilepsy" and has approved this program as part of a comprehensive Improvement in Medical Practice (PIP) program, which is mandated by the ABMS as a necessary component of maintenance of certification.

NOTE: Purchasing this PI CME activity does not enroll the purchaser in the Maintenance of Certification (MOC) program. For more information about MOC, please contact that American Board of Psychiatry and Neurology directly.

Faculty, Planning Committee, Reviewers’ Disclosures of Financial Relationships

In accordance with the ACCME Standards for Commercial Support, the AES requires that any person who is in a position to control content of a CME activity must disclose all relevant financial relationships that they have with a commercial interest. Unless otherwise indicated (*), none of the planners or faculty of this activity have any financial relationships to disclose. All relevant financial relationships with commercial interests have been mitigated. The following individuals contributed to this activity’s content.


Lindsay M. Higdon, MD, Jefferson University Hospitals, Philadelphia, PA

Sally V. Mathias, MD, University of Kentucky Albert B. Chandler Hospital, Lexington, KY

Puja Patel, MD, Montefiore Medical Center, Bronx, NY

Rebecca Spiegel, MD, Stony Brook Epilepsy Center, Stony Brook, NY


*Anup D. Patel, M.D., Nationwide Children’s Hospital, Columbus, OH - Consultant: Medscape, NeurologyLive, Greenwich Biosciences; Scientific Advisory Board: Neurelis

AES Staff

Joy Keller, MS, RD, MSLIS, AES Senior Manager, Clinical Activities

Cristina Graham, AES Director, Education and Professional Development

AES Staff involved in this activity have indicated they have no financial relationships to disclose relevant to this activity.

CME Reviewer

Derek Bauer, MD, Adult Neurology Clinic, Charlottesville, VA

Additional Information

Resolution of Conflicts of Interest

It is the policy of the American Epilepsy Society to ensure balance, independence, objectivity and scientific rigor. All persons involved in the selection, development and presentation of content are required to disclose any real or apparent conflicts of interest. In accordance with the ACCME Standards for Commercial Support of CME, the AES implemented the mechanisms of prospective peer review of this CME activity, to identify and resolve any conflicts. Additionally, the content of this activity is based on the best available evidence.

Unapproved Use Disclosure

The American Epilepsy Society requires CME authors to disclose to learners when products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not FDA approved); and any limitations on the information that is presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. This information is intended solely for continuing medical education and is not intended to promote off-label use of these medications. If you have questions, contact the medical affairs department of the manufacturer for the most recent prescribing information. Information about pharmaceutical agents/devices that is outside of U.S. Food and Drug Administration approved labeling may be contained in this activity.

Contact Information

For further information on this activity contact the American Epilepsy Society at or call 312.883.3800.

Commercial Support

No commercial support was received for this activity.

Privacy and Confidentiality

The American Epilepsy Society respects the privacy and confidentiality of users of this CME activity. You may access the privacy statement for this activity here.

Policy on Commercial Support and Conflict of Interest

As an ACCME-accredited provider the American Epilepsy Society must ensure 100% compliance with the ACCME Standards for Commercial Support: Standards to Ensure Independence in CME Activities. The American Epilepsy Society has implemented mechanisms, prior to the planning and implementation of this CME activity, to identify and resolve conflicts of interest for all individuals in a position to control content of this CME activity

Disclosure of Unlabeled/Unapproved Uses

This educational activity may include references to the use of products for indications not approved by the FDA. Faculty have agreed to disclose intent to discuss any off-label, experimental, or investigational use of drugs, devices, or equipment or devices in their presentations.  Furthermore, faculty have attested that all the recommendations involving clinical medicine they make in this activity will be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients; and, all scientific research referred to, reported, or used in their presentation in support or justification of a patient care recommendation will conform to the generally accepted standards of experimental design, data collection and analysis.  Faculty opinions expressed with regard to unapproved, investigational or experimental uses of products are solely those of the faculty and are not endorsed by the American Epilepsy Society.


This CME activity is for educational purposes only and does not constitute the opinion or endorsement of, or promotion by, the American Epilepsy Society. Reasonable efforts have been taken to present educational subject matter in a balanced, unbiased fashion, and in compliance with regulatory requirements. However, each activity participant must always use his or her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label, investigational and/or experimental uses.

Availability: On-Demand
Expires on May 04, 2024
Cost: FREE
Credit Offered:
20 CME Credits
20 MOC Points
Contains: 3 Courses
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