VERTEBRAL ARCH NONFUSION AND JUVENILE MYOCLONIC EPILEPSY

Neural tube defects (NTD) are known to occur at a higher rate in pregn ancies of women with epilepsy. Antiepileptic drugs (AEDs), notably val proate (VPA) and carbamazepine (CBZ), have been identified as risk fac tors, but a familial aggregation of this condition also occurs in the absence of pharmacologic teratogens. Spina bifida occulta, defined as a nonsymptomatic nonfusion of vertebral arches, has been suggested to be genetically determined, with an increased prevalence in patients wi th primary generalized epilepsy, and that the presence of this trait i n fetal development can be enhanced pharmacologically to produce NTD s uch as meningomyelocele. In this study, plain abdominal radiographs we re obtained from 56 patients with juvenile myoclonic epilepsy (JME) an d 56 age- and sex-matched controls. The radiographs were presented in a random order to an unbiased radiologist. No difference in prevalence of vertebral arch nonfusion (VAN) was noted between the two groups. E ven if it has no increased frequency in patients with epilepsy, howeve r, VAN is a common radiologic finding, and its relation to symptomatic neural tube defects should be clarified in future studies.