Which of the following drugs is effective as a replacement for sodium valproate in a female of childbearing age group for treatment of juvenile monoclinic epilepsy?

Ans. a. Levetiracetam (Ref: Harrison 19/e p2544, 18/e p3265. 3253)Levetiracetam can be prescribed as monotherapy in a female patient of childbearing age is on valproate for JME, because of no known significant drug interactions. Treatment of Juvenile Myoclonic Epilepsy:Valproate is often used to treat juvenile myoclonic epilepsy.Other epilepsy drugs are effective in juvenile myoclonic epilepsy:LevetiracetamTopiramateLamotrigine Juvenile Myoclonic EpilepsyJuvenile myoclonic epilepsy (JME) is a generalized seizure disorder of unknown cause that appears in early adolescenceCharacterized by bilateral myoclonic jerks that may be single or repetitive.Myoclonic seizures are most frequent in the morning after awakening and can be provoked by sleep deprivation.Consciousness is preserved unless the myoclonus is especially severe.Many patients also experience generalized tonic-clonic seizures, and up to one-third have absence seizures.Although complete remission is relatively uncommon, the seizures respond well to appropriate anticonvulsant medication.There is often a family history of epilepsy, and genetic linkage studies suggest a polygenic cause.Treatment:Valproate is often used to treat juvenile myoclonic epilepsy.Other epilepsy drugs are effective in juvenile myoclonic epilepsy:LevetiracetamTopiramateLamotrigineFor most people with JME, treatment is long-term, and often lifelong.However, treatment is effective, allowing most people with juvenile myoclonic epilepsy to go five years or more between seizures.