Neurodevelopmental outcomes of children born to mothers with epilepsy
Kimford J. Meador, MD
Department of Neurology, Georgetown University Hospital, Washington, DC
Mary L. Zupanc, MD
Department of Neurology, Medical College of Wisconsin, Milwaukee, WI
Correspondence: Kimford J. Meador, MD, Department of Neurology, Georgetown University Hospital, 1st Floor Bles, 3800 Reservoir Rd., NW, Washington, DC 20007; e-mail: email@example.com
Dr. Meador receives grants from GlaxoSmithKline, Novartis, Ortho-McNeil, Pfizer, Shire, and UCB Pharma; is a consultant for GlaxoSmithkline, Elan, Lexicor Health Systems, Neuropace, Novartis, Ortho-McNeil, Pfizer, Shire, and UCB Pharma; and has received honoraria from GlaxoSmithKline, Ortho-McNeil, Pfizer, Shire, and UCB Pharma.
Dr. Zupanc is a consultant for and has received honoraria from GlaxoSmithKline, UCB Pharma, Ortho-McNeil, Cyberonics, and Elan.
Most children born to women with epilepsy are normal, but there is an increased risk of abnormal functional neurodevelopment in these children. Although there are many contributing factors, antiepileptic drugs (AEDs) may play a role. Most women with epilepsy must take AEDs during pregnancy because the potential for injury from seizures to both mother and fetus is a greater risk. AEDs are also used to treat other disorders, including depression and pain. Thus, an understanding of the effects of AEDs on the unborn child is relevant to physicians who treat nonepileptic mothers as well. This review discusses animal and human studies of the neurodevelopmental effects of AEDs and briefly reviews the possible mechanisms underlying these effects. Flaws in the methodology of some studies of these effects require that the results be interpreted cautiously and highlight the need for well-designed studies to explore this issue further.