Which teratogenic medications are associated with congenital facial paralysis?

Updated: Jan 07, 2019
  • Author: Alan D Bruns, MD, FACS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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See the list below:

  • Thalidomide: This sedative and antiemetic is associated with phocomelia, arrested development of the ear, and paralysis of the facial and abducens nerves. This medication is currently used in patients with leprosy, multiple myeloma, other cancer treatments. [14]

  • Misoprostol: This synthetic prostaglandin is used to prevent and treat gastrointestinal lesions induced by nonsteroidal anti-inflammatory drugs. It may stimulate uterine contractions and has been used with mifepristone or methotrexate to induce an abortion. When used alone, up to 80% of pregnancies continue to term. In a study of 96 infants with Möbius syndrome and 96 infants with neural tube defects, 49% of infants with Möbius syndrome were exposed to misoprostol in utero, compared with 3% of infants with neural tube defects. The cause of Möbius syndrome associated with misoprostol may be vascular disruption of the subclavian artery in week 4-6, causing an ischemic brain event. [30]

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