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- $Unique_ID{BRK03737}
- $Pretitle{}
- $Title{Fetal Hydantoin Syndrome}
- $Subject{Fetal Hydantoin Syndrome Dilantin Fetal Effects Of Fetal Dilantin
- Syndrome Fetal Hydantoin Effects Hydantoin Anticonvulsants Fetal Effects Of
- Mephenytoin Fetal Effects Of Mesantoin Fetal Effects Of Phenytoin Fetal
- Effects Of Aarskog Syndrome Noonan Syndrome}
- $Volume{}
- $Log{}
-
- Copyright (C) 1993 National Organization for Rare Disorders, Inc.
-
- 948:
- Fetal Hydantoin Syndrome
-
- ** IMPORTANT **
- It is possible that the main title of the article (Fetal Hydantoin
- Syndrome) is not the name you expected. Please check the SYNONYMS listing to
- find the alternate name and disorder subdivisions covered by this article.
-
- Synonyms
-
- Dilantin, Fetal Effects Of
- Fetal Dilantin Syndrome
- Fetal Hydantoin Effects
- Hydantoin Anticonvulsants, Fetal Effects Of
- Mephenytoin, Fetal Effects Of
- Mesantoin, Fetal Effects Of
- Phenytoin, Fetal Effects Of
-
- Information on the following diseases can be found in the Related
- Disorders section of this report:
-
- Aarskog Syndrome
- Noonan Syndrome
-
- General Discussion
-
- ** REMINDER **
- The Information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
- Fetal Hydantoin Syndrome is a rare disorder that is caused by exposure of
- a fetus to phenytoin (Dilantin) which is an anticonvulsant drug prescribed
- for epilepsy. Major symptoms of this disorder may include abnormalities of
- the skull and facial features, growth deficiencies, underdeveloped nails of
- the fingers and toes, and/or developmental delays.
-
- Symptoms
-
- Fetal Hydantoin Syndrome is typically characterized by altered growth,
- unusual facial features, underdeveloped fingers and toes, and mental
- deficiencies.
-
- The most consistent facial features found in affected infants have been a
- flat bridge of the nose, and eyes that are down-slanted, widely spaced, and
- crossed (strabismus). An underdeveloped vertical groove in the center of the
- upper lip (philtrum), cleft lip and/or palate, drooping eyelids (ptosis), and
- mild webbing of the neck have also been reported.
-
- Growth deficiencies may include underdeveloped fingers and toes,
- malformed nails as well as finger-like thumbs.
-
- It has been estimated that approximately thirty percent of affected
- children with this syndrome have mild to moderate mental retardation which
- may be associated with an abnormally small brain (microencephaly).
-
- Causes
-
- Fetal Hydantoin Syndrome is a rare disorder that is caused by exposure of a
- fetus to phenytoin (Dilantin) which is an anticonvulsant drugs prescribed for
- epilepsy. Not all infants exposed to phenytoin will be affected with the
- disorder. There have been documented cases in which affected and unaffected
- siblings have been exposed to the same amount of this drug. Some scientists
- believe that enzyme differences may determine which sibling will be affected
- with the disorder.
-
- Affected Population
-
- Fetal Hydantoin Syndrome is a rare disorder that affects males and females in
- equal numbers. Approximately eleven percent of infants exposed to hydantoin
- in the womb are affected with the disorder.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of Fetal
- Hydantoin Syndrome. Comparisons may be useful for a differential diagnosis:
-
- Aarskog Syndrome is thought to be inherited as a a sex-linked dominant
- trait. Males with Fetal Hydantoin Syndrome may have symptoms similar to
- those of Aarskog Syndrome. Infants affected with Aarskog Syndrome may have
- widely spaced eyes (hypertelorism) with drooping eyelids (ptosis), and a
- short broad nasal bridge. Short broad fingers and toes as well as stunted
- growth, genital abnormalities and mild mental retardation may also be
- present. (For more information on this disorder, choose "Aarskog Syndrome"
- as your search term in the Rare Disease Database).
-
- Noonan Syndrome is a rare disorder that may be inherited as an autosomal
- dominant or autosomal recessive genetic trait. Symptoms of this disorder may
- also be similar to those of infants affected with Fetal Hydantoin Syndrome.
- This disorder is mainly characterized by a lack of sexual development, short
- stature, possible mental retardation, a webbed neck, widely spaced eyes with
- drooping eyelids, and/or skeletal abnormalities. (For more information on
- this disorder, choose "Noonan Syndrome" as your search term in the Rare
- Disease Database).
-
- Therapies: Standard
-
- It has been suggested that mothers receiving phenytoin (Dilantin) who have
- given birth to an infant affected with Fetal Hydantoin Syndrome be given a
- different anticonvulsant drug during future pregnancies. Some physicians
- change a woman's epilepsy drug during pregnancy from phenytoin to other
- anticonvulsants in order to avoid the possibility of this syndrome in a
- fetus. However, the effect of other seizure medications on a fetus are not
- always well understood.
-
- When cleft lip and/or palate are present the coordinated efforts of a
- team of specialists such as pediatricians, dental specialists, surgeons,
- speech pathologists, and psychologists may be used to plan the child's
- treatment and rehabilitation. Cleft lip may be surgically corrected.
- Generally surgeons repair the lip when the child is still an infant. A
- second surgery is sometimes necessary for cosmetic purposes when the child is
- older.
-
- Cleft palate may be repaired by surgery or covered by an artificial
- device (prosthesis) that closes or blocks the opening. Surgical repair can
- be carried out in stages or in a single operation, according to the nature
- and severity of the defect. The first palate surgery is usually scheduled
- during the toddler period.
-
- Special education and related services will be of benefit to children
- with learning delays. Other treatment is symptomatic and supportive.
-
- Therapies: Investigational
-
- Research on birth defects and their causes is ongoing.
-
- This disease entry is based upon medical information available through
- April 1993. Since NORD's resources are limited, it is not possible to keep
- every entry in the Rare Disease Database completely current and accurate.
- Please check with the agencies listed in the Resources section for the most
- current information about this disorder.
-
- Resources
-
- For more information on Fetal Hydantoin Syndrome, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- NIH/National Institute of Child Health & Human Development (NICHD)
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-5133
-
- For children with clefts a group of specialists called a Cleft Palate
- Team may be of benefit. For information on local teams contact:
-
- American Cleft Palate Cranial Facial Association
- 1218 Granview Ave.
- Pittsburgh, PA 15211
- (412) 681-1376
- (800) 24CLEFT
-
- For genetic information and genetic counseling referrals, please contact:
-
- March of Dimes Birth Defects Foundation
- 1275 Mamaroneck Avenue
- White Plains, NY 10605
- (914) 428-7100
-
- Alliance of Genetic Support Groups
- 35 Wisconsin Circle, Suite 440
- Chevy Chase, MD 20815
- (800) 336-GENE
- (301) 652-5553
-
- References
-
- SMITH'S RECOGNIZABLE PATTERNS OF HUMAN MALFORMATION, 4th Ed.: Kenneth L.
- Jones, M.D., Editor; W.B. Saunders Co., 1988. P. 495.
-
- BIRTH DEFECTS ENCYCLOPEDIA, Mary Louise Buyse, M.D., Editor-In-Chief;
- Blackwell Scientific Publications, 1992. Pp. 714-15.
-
- FETAL HYDANTOIN SYNDROME IN TRIPLETS. A UNIQUE EXPERIMENT OF NATURE:
- S.A. Bustamante, et al.; Am J Dis Child (October, 1978, issue 132(10)). Pp.
- 978-9.
-
- RISKS TO THE OFFSPRING OF WOMEN TREATED WITH HYDANTOIN ANTICONVULSANTS,
- WITH EMPHASIS ON THE FETAL HYDANTOIN SYNDROME: J.W. Hanson, et al.; J
- Pediatr (October, 1976, issue 89(4)). Pp. 662-8.
-
- PRENATAL PREDICTION OF RISK OF THE FETAL HYDANTOIN SYNDROME: B.A.
- Buehler, et al.; N Engl J Med (may, 1990, issue 322(22)). Pp. 1567-72.
-
-