MINOR PHYSICAL ANOMALIES IN OFFSPRING OF MOTHERS WITH EPILEPSY

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.