The Offspring of Epileptic Mothers:
A High-Risk Population?
Hans-Christoph Steinhausen, M.D., Ph.D.
Helga Huth, Ph.D.
Sabine Koch, M.D.
From a theoretical point of view, children of epileptic parents may be regarded as being exposed to a threefold risk. First is the risk of genetic transmission, at least for some types of epilepsy. Next, teratogenic effects resulting from intrauterine exposure to antiepileptic drugs may be manifested in disorders of physical and mental development. Finally, the parental illness may be accompanied by psychopathological disturbances which can influence the child's development.
The model of children at risk via genetic inheritance, in utero effects, and parental psychopathology has already been utilized in the study of various psychiatric disorders; for example, parental schizophrenia (cf. the reviews of Anthony, 1978; Erlenmeyer-Kimling et al., 1980; Garmezy, 1977; Mednick et al., 1979; Sameroff and Seifer, 1981), parental depression (Conners et al., 1979; Cytryn et al., 1982; McKnew et al., 1979; Welner et al., 1977; Winters et al., 1981), and children of alcoholic parents (Steinhausen et al., 1982a, 1982b, 1983).
However, there have been only a few reports on the effects of antiepileptic medications. Among these studies of drug effects on early psychomotor and intellectual development, some have observed an unusually high rate of mentally subnormal children (Hanson et al., 1976; Hanson and Smith, 1975; Hill et al., 1974, 1982; Majewski et al., 1980; Shapiro et al., 1976; Speidel and Meadow, 1972; Vert et al., 1979), results which were not, however, confirmed by others (Dietrich, 1980; Granström, 1979, 1982; Sobczyk et al., 1977). In a retrospective pilot study we have been able to ascertain that preschool-age children of epileptic mothers do not show any increased number of psychiatric symptoms (Huth et al., 1982; Steinhausen et al., 1982a). The limited assessment and the well-known disadvantages of retrospective studies prompted us recently to start a prospectively oriented longitudinal study, of which this is a preliminary report.
We are currently endeavoring to evaluate possible genetic, teratogenic, and environmental effects on the offspring of epileptic parents. Several control groups are used in order to____________________