Tibial Agenesis and Gollop-Wolfgang Complex in Three Siblings Born to an Epileptic Woman Treated with Carbamazepine: Teratogenicity

Abstract

The term "limb deficiency" incorporates absence and/or size reduction of any of the 120 human limb bones, with around 205 identified nosologic entities. Of these, the Gollop-Wolfgang Complex (GWC) is a rare abnormality comprising absence of tibia and ipsilateral forked femur with ectrodactyly. There is scarcity of literature implicating antiepileptic drugs in the etiology of GWC but the teratogenecity of antiepileptics especially valproate is well documented. The management of epilepsy during pregnancy requires a balance between control, the risks involved in uncontrolled seizures and the teratogenecity of antiepileptic drugs. This study presents three siblings with GWC and tibial agenesis whose epileptic mother had been on treatment with carbamazepine for 10 years. To the author's knowledge, this is the first time that carbamazepine has been implicated in causation of GWC/tibial agenesis.

Early Outcome After Limb Salvage Surgery of a Rare Case of Gollop-Wolfgang Complex in a Limited Resource Setting in Africa

“…The eponym «Gollop-Wolfgang complex» was introduced in 1986 by Lurie & Ilyina [6]. Several associations between GWC and maternal use of antiepileptic drugs, most notably that of sodium valproate and cabamazepines, have been documented previously [7,8]. The best treatment option for patients with GWC is early knee disarticulation and resection of the protruded bifurcated femur followed by fitting of a modern prosthesis [9][10][11].…”