We wanted to notify your readers of an oversight and omission that pertains to our evidence-based recommendation for the preconception care of women with seizure disorders. In our published discussion of the “Recommendations of other groups” for women with seizure disorders, we misstated that the American Academy of Neurology recommends folic acid supplementation of 0.4 mg/d (rather than at least 0.4 mg/d) for all women, with or without a seizure disorder. Since the publication of our original article, the American Academy of Neurology has updated their practice guideline to acknowledge that there is insufficient published information to address dosing of folic acid for women with seizure disorders and/or who are taking anticonvulsant medications. The updated practice guideline specifies that all women of reproductive potential, with or without a seizure disorder, should be encouraged to take at least 0.4 mg of folic acid daily before conception and during pregnancy.

In addition, in our discussion of the educational bulletin of the American College of Obstetricians and Gynecologists, we did not include their statement that a preconception dosage of folic acid of 4 mg/d would seem appropriate for the patient who is receiving anticonvulsant medications, while acknowledging that the optimal dosage of folic acid for the prevention of drug-associated neural tube defects is unknown. Since the publication of our original article, the American College of Obstetricians and Gynecologists has also addressed anticonvulsant use and folic acid supplementation in a recent practice bulletin, specifying that, although the effectiveness of folic acid supplementation in the prevention of drug-associated neural tube defects has not been documented, folic acid supplementation of 4 mg/d should be offered preconceptionally and for the first trimester of pregnancy for women who are receiving anticonvulsants.

In light of these clarifications, our recommendation for the preconception care of women of reproductive age should read as follows: those women who are planning a pregnancy or who could become pregnant should be evaluated fully for consideration of alteration or withdrawal of the anticonvulsant regimen before conception and should initiate folic acid supplementation of at least 0.4 mg/d and possibly as much as 4 mg/d for women who are receiving anticonvulsant medications, particularly valproate and/or carbamazepine.

We apologize for any confusion that the omissions from our originally published article may have caused your readership.