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Published on: September 20, 2024
Early cognitive development in children born to women with epilepsy: a prospective report
Rebecca L Bromley1, George Mawer, Jenna Love
1Department Neurological Science, University of Liverpool, United Kingdom.
Insights
Children exposed to sodium valproate in utero face an increased risk of delayed early development. Monitoring is crucial for children exposed to antiepileptic drugs to ensure timely intervention.
Area of Science:
- Neurodevelopmental Pediatrics
- Pharmacology
- Epilepsy Research
Background:
- Epilepsy affects women of childbearing age.
- Antiepileptic drugs (AEDs) are often necessary for managing epilepsy during pregnancy.
- The impact of prenatal AED exposure on early cognitive development requires thorough investigation.
Purpose of the Study:
- To assess and compare the early cognitive development of children born to mothers with epilepsy against a control group.
- To identify potential risks associated with specific antiepileptic drugs on neurodevelopment.
Main Methods:
- Prospective study involving 198 children of women with epilepsy and 230 controls.
- Griffiths Mental Development Scales used for assessments before age 2.
- Blinded assessors ensured objectivity, unaware of maternal epilepsy or AED type.
Main Results:
- Sodium valproate exposure was linked to a statistically significant increased risk of delayed early development.
- Linear regression confirmed a significant negative effect of sodium valproate on developmental level, independent of confounders.
- Carbamazepine and lamotrigine exposure did not show significant differences in overall developmental ability compared to controls.
Conclusions:
- Women with epilepsy should receive comprehensive counseling on prenatal AED risks for informed decision-making.
- Close monitoring of children exposed prenatally to AEDs is recommended for early intervention opportunities.
Purpose:
In this prospective study the early cognitive development of children born to women with epilepsy (n = 198) was assessed and compared to a group of children representative of the general population (n = 230).
Methods:
The children were assessed when younger than the age of 2 years using the Griffiths Mental Development Scales, either in their local participating hospital or in their home. The assessments were completed by an assessor who was blinded to whether the child's mother had epilepsy and to antiepileptic drug type.
Results:
Children exposed to sodium valproate had a statistically significant increased risk of delayed early development in comparison to the control children. Linear regression analysis showed a statistically significant effect of sodium valproate exposure on the child's overall developmental level that was not accounted for by confounding variables. Delayed early development is also noted for children within an ad hoc group of less commonly utilized antiepileptic drugs, although conclusions cannot be drawn due to the size of this group (n = 13). Children exposed to either carbamazepine or lamotrigine in utero did not differ significantly in their overall developmental ability. Differences noted in specific developmental areas for these two groups were not statistically significant after the control for confounders such as socioeconomic status and maternal IQ.
Discussion:
Women with epilepsy should be informed of the risks posed to their potential offspring prior to pregnancy to allow for informed decisions regarding treatment. Children exposed in utero to antiepileptic drugs should be monitored throughout childhood to allow for early intervention when necessary.
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