Minor physical anomalies are markers of altered morphogenesis during t
he fetal period. They are clinically significant because, when multipl
e in a child, they may be signs of serious underlying defects such as
mental deficiency or major malformation. Seven prospective studies hav
e investigated the frequency of minor anomalies in children of mothers
with epilepsy. An increased number of characteristic craniofacial and
digital anomalies such as epicanthal folds, hypertelorism, short low-
bridged nose and distal digital hypoplasia have been observed in these
children compared to control children of parents without epilepsy. Of
the minor anomalies investigated, only distal digital hypoplasia has
shown a consistent association with prenatal anti-epileptic drug (phen
ytoin) exposure. Increased frequency of epicanthus appears to be indep
endent of drug exposure but associated with increased occurrence of th
e same feature in mothers with epilepsy. These characteristic minor an
omalies have not been found to be associated with serious developmenta
l defects when studied prospectively.