Neocerebellar Hypoplasia in a Neonate Following Intra-uterine Exposure to Anticonvulsants

An infant with dysmorphic features was born to an epileptic mother who had taken phenytoin and sodium valproate throughout pregnancy. The infant began to have intractable seizures 10 minutes after delivery, and retrospective reports from the mother suggested they may have occurred in utero. Ultrasound examination of the brain showed a very wide subarachnoid space and CT confirmed cerebral and cerebellar underdevelopment. The infant died at three days of age and autopsy revealed a small brain with neocerebellar hypoplasia. This case might represent an extreme example of anticonvulsant teratogenicity.