Aggarwal Anju, Mittal Hema, Patil Rahul, Debnath Sanjib, Rai Anuradha
Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India.
J Neurosci Rural Pract. 2013 Jul;4(3):288-91. doi: 10.4103/0976-3147.118781.
To study the profile of children with developmental delay and microcephaly.
Children attending child development clinic with developmental delay were evaluated as per protocol. Z scores of head circumference were calculated using WHO charts. Clinical, radiological and etiological profile of those with microcephaly and those without was compared.
Of the 414 children with developmental delay 231 had microcephaly (z score ≤ -3). Mean age of children with microcephaly was 35.1 ± 27.9 months (range 4-184), males (72.7%). Comorbidities were epilepsy (42.9%), visual abnormality (26.4%), hearing abnormality (16.9%). Mean DQ was 29.75 + 17.8 in those with microcephaly was significantly lower compared to the rest (P = 0.002). Secondary microcephaly was associated with cerebral palsy in 69.7%. Other causes were congenital infections (4), inborn error of metabolism (3), post-meningoencephalitis (5), malformations (12), and syndromic (13). Neuroimaging was done in 118 (51.1%) cases of which 104 (88.1%) were abnormal. On comparison children with microcephaly had more epilepsy, lower developmental quotient, vision abnormalities findings as compared to normocephalic children with developmental delay (P > 0.05).
Microcephaly was associated with lower, DQ, higher comorbidities in children with developmental delay. Spastic CP is commonly associated with microcephaly.
研究发育迟缓及小头畸形儿童的情况。
按照方案对儿童发育门诊中发育迟缓的儿童进行评估。使用世界卫生组织生长曲线表计算头围的Z评分。比较小头畸形儿童与非小头畸形儿童的临床、影像学及病因学情况。
在414名发育迟缓儿童中，231名有小头畸形（Z评分≤ -3）。小头畸形儿童的平均年龄为35.1±27.9个月（范围4 - 184个月），男性占72.7%。合并症有癫痫（42.9%）、视觉异常（26.4%）、听力异常（16.9%）。小头畸形儿童的平均发育商为29.75 + 17.8，显著低于其余儿童（P = 0.002）。继发性小头畸形在69.7%的病例中与脑性瘫痪相关。其他病因包括先天性感染（4例）、先天性代谢缺陷（3例）、脑膜脑炎后（5例）、畸形（12例）及综合征性（13例）。118例（51.1%）进行了神经影像学检查，其中104例（88.1%）异常。与发育迟缓的头围正常儿童相比，小头畸形儿童癫痫更多、发育商更低、视觉异常更多（P > 0.05）。
小头畸形与发育迟缓儿童较低的发育商及较高的合并症相关。痉挛型脑性瘫痪常与小头畸形相关。
