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Craniofacial Defects and Depakote

What are craniofacial defects?

Craniofacial defects refer to congenital birth defects of the face and head involving bones or soft tissue.

Depakote (Divalproex sodium) has been assigned to pregnancy category D by the FDA. Evidence suggests that there is an increased risk of other major birth defects such as craniofacial defects. There is a four-fold increase in congenital malformations reported among infants with Depakote-like exposed mothers compared with those treated with other antiepileptic therapies.

What are some common craniofacial defects?

Cleft lip and cleft palate are the most common congenital birth defects.

Cleft palate happens when the roof of the mouth does not completely close, leaving a gap that can extend into the nasal cavity. The cleft may involve either side of the palate. The cleft may also include the lip.

The cleft lip is a birth defect in which the lip doesn't completely form. The degree of the cleft lip can be from mild to severe.

Craniosynostosis means fused bones of the skull. Some children are born with it or later develop it. Different bones that fit together like a jigsaw puzzle make up the skull. The areas where the bones meet one another are called sutures. Bones expand and grow but when they don't, it's called craniosynostosis which leads to an abnormal shaped skull.

Hemangioma is a type of birthmark. Hemangiomas may be present at birth resembling a faint red mark or appear in the first months after birth. A hemangioma is also known as a port wine stain, strawberry hemangioma, and salmon patch.

Hemifacial Microsomia Syndrome is a condition in which the lower half of one side of the face does not grow normally and the child has a partially formed or missing ear and undeveloped mouth and jaw. Sometimes, both sides of the face can be affected and may involve the skull, as well as the face. Hemifacial microsomia is also known as Goldenhar syndrome, brachial arch syndrome, facio-auriculo-vertebral syndrome (FAV), oculo-auriculo-vertebral spectrum (OAV), or lateral facial dysplasia.

What causes of craniofacial defects?

During the first six to eight weeks of pregnancy, the shape of the embryo's head is formed. Five primitive tissue lobes grow, and if these tissues fail to develop or meet and fuse correctly, craniofacial deformities occur. Development of the face and skull is susceptible to anti-epileptic drugs such as Depakote as well as environmental and genetic factors.

How are craniofacial defects treated?

Surgical treatment is advisable before one year of age as the bones are still soft and easier to work with. Surgery may be performed in stages to obtain optimum results. Craniofacial Defects do not exist in isolation and may be accompanied by other congenital abnormalities.

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