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Neonates with fetal alcohol syndrome are usually jittery. Seizures are not frequent except in neonates with midline prosencephalic abnormalities. Midline prosencephalic abnormalities are agenesis of the corpus callosum, septo-optic dysplasia, and holoprosencephaly. Other brain malformations that occur in fetal alcohol syndrome are errors in neuronal and glial proliferation and neuronal migration. Intelligence quotient tends to correlate with dysmorphic features—the more dysmorphic, the more delayed. An EEG pattern characterized by excessive hypersynchronicity has been reported. Cardiac septal defect occurs in about half of these patients.

Anticonvulsant Fetal Syndrome
The maternal use of anticonvulsant drugs during pregnancy, especially phenytoin, phenobarbital, or primidone, may produce congenital microcephaly. Carbamezapine and valproic acid have been involved in producing fetal malformation syndromes, but microcephaly is not one of their major features. Neonates with fetal exposure to anticonvulsant drugs often have characteristic facies. Their most salient features include large fontanelles, metopic suture ridging, ocular hypertelorism, epicanthal folds, broad nasal bridge, and hypoplasia of the distal phalanges and nails. Bifid or shawl scrotum, cardiac abnormalities, and cleft lip and palate may also occur. The teratogenic effect of these drugs may be related to their conversion to their epoxide compounds and the inability of the fetal liver to transform them. Patients with fetal anticonvulsant syndrome are developmentally delayed. The diagnosis is made by maternal history of anticonvulsant drug intake during pregnancy.

 

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Haslam, 1987 Volpe, 1995