Severe microcephaly(Small head)

4th Pediatric Infectious Diseases Conference

ISSN 0973 - 0958

Childhood Ailments

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Question
Thanks for answering my earlier query. Accordingly, I understand that my child has severe microcephaly (small head) due to the birth asphyxia. With no development of milestones at even 5 months of age and early closure of the fontanelle (soft spot) on the skull, her prognosis is poor. She seems to have developed cerebral palsy. Now in her 8th month, her activities include crying for Milk or if when she needs her diaper to be changed, saying "hu-goo" and when someone whistles she smiles and plays. She can hold up her head and can roll over when in mood. But she does not sit without support or crawl. Trust that you can answer my further queries : 1) Why do her palms and feet turn light blue sometimes for 10 to 15 minutes ( 3 to 4 times a week). Her head has grown only 2 cms since her birth. 2) Now after 8 months she has started to have some convulsions (10 seconds, about 3 to 4 times daily). They continued for a week and then stopped. Will giving Gardinal stop these convulsions permanently? If not given timely, will it damage her brain or other activities more ? 3) We have started her physotherapy since last 2 months, but response is not very encouraging. Will she be able to walk ? 4) If I plan for a second child, will she/he again be a CP Thanks in advance.
Answer
If her palms and feet seem to turn blue, one needs to rule out a heart disease. Gardinal will control the convulsions (it does not cure it). Sometimes these children may have intractable convulsions and other drugs may also be required to control the seizures. If the fits are controlled on Gardinal, one may continue with the same. An EEG may be useful to determine which is the best antiepileptic for the child. If convulsions recur or persist for a long time, chances of brain damage increases as with every convulsion the metabolism of the brain increases whereby the demand is more than the supply. This can lead to cell death in the brain. Since the child can roll over at 8 months, one may have to wait and watch regarding the walking. If she can achieve sitting by 2 years, chances are there that she may be able to stand. Regarding the next pregnancy, one may have to be very sure that cerebral palsy in the 1st child is due to birth asphyxia and not due to any other cause. Chances of birth asphyxia in the next pregnancy is the same as for anyone else. One can confirm the birth asphyxia related brain damage in the 1st child by doing an MRI of the brain. However, if the cause is intrauterine infection or a metabolic cause, one may need to know the exact diagnosis to determine what are the chances in the next pregnancy. Back to All Questions

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