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Cited by 56Fetal and Pediatric Neurological DisordersPharmacological Effects and Toxicity StudiesPregnancy and Medication Impact

Thalidomide and misoprostol: Ophthalmologic manifestations and associations both expected and unexpected

Miller, Marilyn T., Ventura, Liana, Strömland, Kerstin·2009·Birth Defects Research Part A Clinical and Molecular Teratology
DOI 10.1002/bdra.20609
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Abstract

Thalidomide is a very potent teratogen capable of causing severe systemic malformations if the fetus is exposed during the sensitive period. Although structural anomalies of the eye can occur from thalidomide exposure, the most frequent eye complication is secondary to damage to the cranial nuclei in the brain stem, resulting in aberrant neurologic connections causing a condition of abnormal ocular movement, Duane syndrome. A less frequent anomalous neurologic complication is tearing when eating (paradoxical gustolacrimal tearing or "crocodile tears") or lack of emotional tearing. The involvement of the 6th and 7th cranial nerves, often seen together in the thalidomide-affected individual, is also characteristic of Möbius syndrome/sequence. This syndrome usually occurs sporadically, but characteristic findings of this condition have also been observed in South American children who were born after an unsuccessful attempt to induce abortion with the prostaglandin drug misoprostol (Cytotec). Aberrant tearing also occurs in some individuals with Möbius syndrome. Autism spectrum disorder (ASD), an unexpected associated finding in a Swedish thalidomide study, is now also noted in Möbius studies, in patients both with and without exposure to misoprostol.

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Crossref · 10.1002/bdra.20609

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  • Abnormal FC between STG and VSi may underlie the hypothesized deficiency of social rewards in ASD.

    “Given the role of the VSi in reward mechanisms, abnormal FC between these regions may underlie the hypothesized deficiency of social rewards in ASD (93).”

    From Aberrant Striatal Functional Connectivity in Children with Autism (2011) · cites this paper as [93]

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Authors
Miller, M. T., Ventura, L., & Strömland, K.
Affiliations
  • University of Illinois Chicago (US)
  • Fundação Altino Ventura (BR)
  • Drottning Silvias barn- och ungdomssjukhus (SE)
Corresponding author
Miller, Marilyn T.
ORCID
Venue
Birth Defects Research Part A Clinical and Molecular Teratology
Publisher
Wiley
Published
2009-08
Volume
85
Issue
8
Pages
667-676
ISSN
  • 1542-0752 (ISSN-L)
  • 1542-0760
DOI
10.1002/bdra.20609
OpenAlex
W2077663854
Cited by
56
References
98
Citations by year
2026: 1 · 2025: 2 · 2024: 5 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 5 · 2017: 5 · 2016: 3 · 2015: 3 · 2014: 4 · 2013: 2 · 2012: 3
FWCI
0.54
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Birth Defects Research Part A Clinical and Molecular Teratology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Eye Institute (EY-1792, P30EY001792)
  • National Institute on Deafness and Other Communication Disorders (U19HD/DC35466)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
Keywords
thalidomide, misoprostol, ocular manifestations, Duane retraction syndrome, Möbius syndrome, autism spectrum disorder, abortion, prostaglandins, teratogenicity, ocular malformations
MeSH terms
Abnormalities, Drug-Induced, Adult, Autistic Disorder, Child, Child, Preschool, Cranial Nerves, Eye Abnormalities, Female, Humans, Infant, Lacrimal Apparatus Diseases, Pregnancy, Teratogens, Thalidomide, Misoprostol, Mobius Syndrome, Embryonic Development

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