Intelligence and physical features of children of women with epilepsy

The teratogenicity of maternal epilepsy has been attributed to several fact ors, including the antiepileptic drugs taken to prevent seizures during pre gnancy, the occurrence of seizures during pregnancy, and the factors in the mother that caused her to have epilepsy. We have addressed the hypothesis that the children of women who have a history of epilepsy (seizure history) , but who took no antiepileptic drugs (AED) and had no tonic-clonic seizure s in pregnancy, have an increased risk of malformations and diminished inte lligence. The frequency of cognitive dysfunction was determined in 57 seizu re history and 57 matched control children aged 6-16 years. The masked eval uation of the children included a physical and neurologic examination and t esting with the Wechsler Intelligence Scale for Children-Revised (WISC-R) a nd a systematic physical examination for the features of the fetal AED synd rome. The evaluation of both parents of each child included a test of reaso ning (Ravens Progressive Matrix) and a physical examination. There were no differences between the two groups of children in either IQ scores or physi cal features; none of the seizure history children was judged to have the " anticonvulsant face" or digit hypoplasia. This study had 80% power to rule out a difference of seven or move IQ points between the two groups, based o n a two-sided test at a 5% level of significance. Our confidence in conclud ing that there was no difference between seizure history and control infant s was strengthened by the fact that no statistically significant difference s were observed with respect to multiple outcomes, including eight related measures of intelligence. Thirty (53%) of the seizure history mothers resum ed taking AED after the birth of the child we evaluated. Additional studies are needed to address the teratogenicity of the antiepileptic drugs as mon otherapy. (C) 2000 Wiley-Liss, Inc.