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Birth defects: 10 case reports In a study (Between April 2013 and September 2016), 10 children [3 girls and 7 boys; exact ages not stated] were described, who developed Arnold-Chiari malformation, clinodactyly and cardiac defects (1 patient), thumb hypoplasia, syndactyly and cardiac defects (1 patient), clubfoot (1 patient), hypospadias (1 patient), macrocephaly, facial dysmorphic features and ankyloglossia (1 patient), genital defects (1 patient), toe aplasia and syndactyly (2 patients), cryptorchidism (1 patient) and ventricular septal defects (bulbus cordis and cardiac septal closure) (1 patient) following in-utero exposure of carbamazepine (3 patients), levetiracetam (1 patient), valproic acid (2 patients), levetiracetam and valproic acid (1 patients), clonazepam and valproic acid (1 patient), pregabalin and topiramate (1 patient) and valproic acid and lamotrigine (1 patient). The mothers of the children had a history of generalised epilepsy (5 mothers) and focal epilepsy (5 mothers). The mothers had received valproic acid 1000-1500 mg/day (n=2), carbamazepine 400-1200 mg/day (n=3), levetiracetam 1000 mg/day (n=1), levetiracetam 1500 mg/day and valproic acid 1000 mg/day (n=1), clonazepam 0.25 mg/day and valproic acid 800 mg/day (n=1), pregabalin 450 mg/day and topiramate 300 mg/day (n=1) and valproic acid 1000 mg/day and lamotrigine 200 mg/day (n=1) during first trimester of pregnancy. Subsequently, the children of the mothers developed birth defects presented as Arnold-Chiari malformation, clinodactyly and cardiac defects (n=1), thumb hypoplasia, syndactyly and cardiac defects (n=1), clubfoot (n=1), hypospadias (n=1), macrocephaly, facial dysmorphic features and ankyloglossia (n=1), genital defects (n=1), toe aplasia and syndactyly (n=2), cryptorchidism (n=1) and ventricular septal defects (bulbus cordis and cardiac septal closure) (n=1). Nine of the ten mothers had also received folic acid 5 mg/day during pregnancy [durations of treatments to reactions onsets and outcomes not stated]. Perucca P, et al. Antiepileptic Drug Teratogenicity and De Novo Genetic Variation Load. Annals of Neurology 87: 897-906, No. 6, Jun 2020. Available from: URL: http:// 803516181 doi.org/10.1002/ana.25724

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Reactions 21 Nov 2020 No. 1831