Microcephaly is a rare neurological condition in which a baby’s head is smaller than average for an infant’s size and age. The baby is either born with a smaller head (congenital), or the condition develops as the baby gets older (acquired). Microcephaly is rare, occurring in 2-12 babies per 10,000 births.
The main defining feature of microcephaly is decreased head circumference, the condition also has other effects on health that can limit quality of life and impair development.
The effects of microcephaly on development can range from mild to severe, and might include –
• delayed development, such as learning to speak, stand, sit, or walk at a later age than other children at a similar stage
• learning difficulties
• movement and balance issues
• a high-pitched cry
• issues with feeding, such as dysphagia, or difficulty swallowing
• hearing loss
• reduced vision from lesions on the retina, the area at the back of the eye
• distorted facial features and expressions
• short stature
Microcephaly usually is the result of a problem with brain development, which can occur in the womb (congenital) or during infancy. Microcephaly may be genetic. Other causes may include:
• Craniosynostosis.Early fusing of the joints (sutures) between the bony plates that form an infant’s skull keeps the brain from growing. It’s surgery relieves pressure on the brain, giving it enough space to grow and develop.
• Genetic changes. Down syndrome and other conditions may result in microcephaly.
• Decreased oxygen to the fetal brain (cerebral anoxia). Certain complications of pregnancy or delivery can impair oxygen delivery to a baby’s brain.
• Infections passed to the fetus during pregnancy.These include toxoplasmosis, cytomegalovirus, German measles (rubella), chickenpox (varicella) and Zika virus.
• Exposure to drugs, alcohol or certain toxic chemicals in the womb.Any of these may affect fetal brain development during pregnancy.
• Severe malnutrition. Not getting enough nutrients during pregnancy may hurt fetal brain development.
• Uncontrolled phenylketonuria, also known as PKU, in the mother.PKU hampers the mother’s ability to break down the amino acid phenylalanine and may affect brain development of the fetus during pregnancy.
Some children with microcephaly achieve developmental milestones even though their heads will always be small for their age and sex. But depending on the cause and severity of the microcephaly, complications may include:
• Developmental delays, including speech and movement
• Difficulties with coordination and balance
• Dwarfism or short stature
• Facial distortions
• Intellectual delays
Microcephaly can sometimes be diagnosed before birth by prenatal ultrasound. In order to make the diagnosis while the fetus is still in the uterus, the ultrasound should be done late in the second trimester or in the third trimester.
After the baby is born, microcephaly can be diagnosed by measuring the baby’s head circumference (all the way around) and comparing it with normal head sizes of newborns. The doctor will also perform a complete physical examination and obtain a complete prenatal and birth history of the child. The doctor might ask the parents about developmental milestones such as crawling and walking, since microcephaly is often accompanied by intellectual disabilities.
No treatment or cure is currently available for microcephaly.
Instead, treatment focuses on managing the condition and relieving linked health problems, such as seizures. If an ongoing process is contributing to the microcephaly, such as malnutrition, healthcare professionals will also address this.
Infants with mild microcephaly typically only require routine check-ups. However, those with a more severe form of the condition may require early childhood intervention programs to strengthen their physical and intellectual capabilities.These programs will often include speech, physical, and occupational therapies.
The prognosis for a child who has microcephaly depends on the other medical conditions the child has. In general, life expectancy for children who have microcephaly is reduced, and the prospects of attaining normal brain function is poor.
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