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Intracranial arteriovenous malformation with maternal carbamazepine use
Manish Narang1, Dheeraj Shah, Gupta Natasha
1Department of Pediatrics, University College of Medical Sciences and GTB Hospital, Delhi, India. manish_2710@yahoo.com
Insights
Maternal carbamazepine therapy during pregnancy may increase a child's risk of developing arteriovenous malformations and intracranial hemorrhage, potentially as part of fetal anticonvulsant syndrome.
Area of Science:
- Neurology
- Teratology
- Pediatrics
Background:
- Carbamazepine is an anticonvulsant medication commonly prescribed for epilepsy.
- Prolonged maternal use of carbamazepine during pregnancy has been linked to various congenital anomalies.
- Fetal anticonvulsant syndrome encompasses a range of developmental abnormalities associated with prenatal exposure to anticonvulsant drugs.
Observation:
- A 1.5-month-old infant presented with recurrent seizures.
- The infant exhibited dysmorphic facial features (abnormal facies).
- Neuroimaging revealed arteriovenous malformation and intracranial hemorrhage.
Findings:
- The infant's presentation suggests a potential association between maternal carbamazepine therapy and the development of arteriovenous malformations.
- Intracranial hemorrhage in the infant may be secondary to the arteriovenous malformation.
- These findings align with the potential clinical profile of fetal anticonvulsant syndrome.
Implications:
- This case highlights the importance of monitoring infants born to mothers on carbamazepine therapy for neurological and vascular abnormalities.
- Further research is warranted to elucidate the precise mechanisms linking carbamazepine exposure to vascular malformations.
- Clinicians should consider fetal anticonvulsant syndrome in the differential diagnosis of neonates with unexplained seizures and congenital anomalies following maternal anticonvulsant use.
Abstract:
1 1/2 month old child born to primigravida mother on prolonged carbamazepine therapy presented with recurrent seizures. The child had abnormal facies and was diagnosed to be having arteriovenous malformation with intracranial hemorrhage on neuroimaging. This case suggests that development of arteriovenous malformation in a child with maternal carbamazepine therapy may occur as a part of clinical profile of 'fetal anticonvulsant syndrome'.
