Friday, August 21, 2009
Microcephaly ~ Devang Chavan
When I went to his class, he was cleaning coriander leaves, slowly and carefully, observing each leaf as he cut off the edges and placed the leaves aside with the bunch of other leaves.
Devang Chavan is ten year old shy kid, who is very active and independent in all his personal skills. He can read and write simple text, good in functional mathematics and can perform simple task independently. He helps his mom at home by running few errands like buying grocery from a store, or helping at home.
He suffers from Microcephaly, which is a medical condition in which the circumference of the head is smaller than normal because the brain has not developed properly or has stopped growing.
Microcephaly can be present at birth or it may develop in the first few years of life. It is most often caused by genetic abnormalities that interfere with the growth of the cerebral cortex during the early months of fetal development. It is associated with Down’s syndrome, chromosomal syndromes, and neurometabolic syndromes.
Babies may also be born with microcephaly if, during pregnancy, their mother abused drugs or alcohol, became infected with German measles, or chicken pox virus, was exposed to certain toxic chemicals, or had untreated phenylketonuria (PKU).
Babies born with microcephaly will have a smaller than normal head that will fail to grow as they progress through infancy. Depending on the severity of the accompanying syndrome, children with microcephaly may have mental retardation, delayed motor functions and speech, facial distortions, dwarfism or short stature, hyperactivity, seizures, difficulties with coordination and balance, and other brain or neurological abnormalities. Some children with microcephaly will have normal intelligence and a head that will grow bigger, but they will track below the normal growth curves for head circumference.
Devang was five years old when he was admitted to Swami Brahamanand School, centre for Mentally challenged. He was very restless and hyperactive. His speech was limited to few words. He had the history of prolong illness and had to be hospitalized several times for diarrhea, respiratory track infection and convulsions. His development milestones were delayed from birth.
Over the period of six years, he has shown marked improvement in behavior and is quite obedient and well mannered. He is shy and does not interact freely in the company of strangers. He takes active part in sports and extra curriculum activities and is being trained in pre-vocational skills.
Children, like Devang, will only have mild disability, especially if they are otherwise growing and developing normally, will have normal intelligence and continue to develop and meet regular age-appropriate milestones.
There is no treatment for microcephaly that can return a child’s head to a normal size or shape. Treatment focuses on ways to decrease the impact of the associated deformities and neurological disabilities. Children with microcephaly and developmental delays are usually evaluated by a pediatric neurologist and followed by a medical management team.
Early childhood intervention programs that involve physical, speech, and occupational therapists help to maximize abilities and minimize dysfunction. Medications are often used to control seizures, hyperactivity, and neuromuscular symptoms. Genetic counseling may help families understand the risk for microcephaly in subsequent pregnancies.
However, ‘The National Institute of Neurological Disorders and Stroke’ (NINDS) conducts research relating to microcephaly in its laboratories at the National Institutes of Health (NIH) and supports additional research through grants to major medical institutions across the country. A small group of researchers studying a rare neurometabolic syndrome (3-PGDH), which causes microcephaly, have successfully used amino acid replacement therapy to reduce and prevent seizures.