Epilepsy

Question 1

What are the features of fetal hydantoin syndrome?

Answer 1

Major and minor congenital malformations;

Major
- neural tube defects (in 1- 3.8%)
- orofacial clefts (cleft lip/palate)
-congenital heart defects
- IUGR, microcephaly

Minor
- dysmorphic features (low set, posteriorly rotated ears, V-shaped brows, broad nasal bridge, irregular teeth)
- hypertelorism
- Midface hypoplasia (may indicate reduced cognitive function
- hypoplastic nails and distal digits
- strabismus
- club foot

FHS= characteristic faces + MCMs +/- neuto delay

Question 2

When is the risk of breakthrough seizures highest?

Answer 2

Postpartum

• Lack of sleep, anxiety/stress, altered compliance with treatment, hormonal/neurochemical biological changes