Women with epilepsy frequently require antiseizure medication (ASM) during pregnancy, and precise knowledge is needed about the safety for the exposed child.¹ Five in 1000 pregnant women use ASMs, and this use is increasing.^1,2 Discontinuation before or during pregnancy is associated with uncontrolled seizures and increased maternal mortality.^3,4 This places the patient and physician in a difficult position because some ASMs are teratogenic and may increase the risk of neurodevelopmental disorders.^5,6 Previous studies have shown a 3- to 5-fold increased risk of autism spectrum disorder (ASD) and intellectual disability (ID) in children after prenatal exposure to valproate.^7-10 However, for most other ASMs, the risk of neurodevelopmental disorders after prenatal exposure remains uncertain despite their frequent use.^5,7-15 The risk is unknown for commonly used combination therapies, but in some patients, seizure control can only be achieved by combining different ASMs.¹⁶

Children exposed to antiepileptic drugs (AEDs) during pregnancy have an increased risk of autistic traits.^1-5 Autistic traits include impairment of social skills and communication as well as stereotyped or repetitive behavior or interests.⁶ These traits represent the core symptoms in autism spectrum disorders and often coexist with other neuropsychiatric diseases. Embryotoxic mechanisms and gene-environmental interactions are probably essential causes of autism.^7,8

The Journal of Headache and Pain is a peer-reviewed open access journal published under the brand SpringerOpen. It is specifically dedicated to researchers involved in all aspects of headache and related pain, including theory, methodology, clinical practice and care. The journal's scope is broad, reflecting the wide application of scientific advances to every branch of headache and related pain management. Within a multidisciplinary perspective, the Journal covers headache and related pain syndromes in the following fields: genetics, neurology, internal medicine, clinical pharmacology, child neuropediatrics, anesthesiology, rheumatology, otology, dentistry, neurotraumatology, neurosurgery, psychiatry, pain management, and addiction. The Journal of Headache and Pain publishes original papers, reviews, rapid communications, brief reports, and letters pertinent to the various aspects of headache and related pain. Researchers in all basic and clinical fields of headache and related pain, from molecular biology to genetics, from epidemiology to classification, from quality of life assessment to clinical trials, are becoming increasingly aware of the importance of this medical specialty. Official Journal of the European Headache Federation Official Journal of Lifting The Burden - The Global Campaign against Headache For authors and readers: All articles are published under the Creative Commons Attribution licence. You can read, redistribute and reuse the articles for free, as long as you cite the authors of the original work properly. The journal went open access in 2011, which means that all articles published since then are freely available online.