Problems present from Birth

---Surprisingly, many children are born with brain impairment affecting one or more senses, muscle control, mental ability or all three. While some suffer grave mental or physical handicap, others appear almost normal. The root of such a problem may be an inherited defect, damage sustained in the womb, or injury occurring at or after birth. The commonest malformations affecting the brain and spinal cord are hydrocephalus and spina bifida. In hydrocephalus ("water-filled brain") prebirth brain malformations or inflammation traps cerebrospinal fluid in the brain’s natural cavities. After birth, fluid dammed up in the head enlarges the skull, and presses hard on the brain, perhaps destroying tissue. The baby suffers fits, blindness, paralysis and death within two teats unless fitted with a special tube to drain excess fluid from the brain. Hydrocephalus often occurs with spina bifida ("cleft spine"), a condition where failure of the some vertebrae to fuse lets part of the spinal cord protrude.

---Brain defects arising before, during or soon after birth accounts for the many forms of so-called cerebral palsy. Causes include too little oxygen or glucose reaching the brain, actual injury during a difficult birth. Often damage affects mainly one cerebral hemisphere to produce hemiplegia - weakness or paralysis of the opposite side of the body. Athetosis (involuntary writhing movements of limbs and face) combined with speech difficulty may make someone with cerebral palsy seem mentally strange. Yet many with this condition have normal intelligence. Care during pregnancy and medical skill at the birth may help to prevent babies from born with cerebral palsy.

---Several inborn conditions cause serious effects including mental retardation. Of those due to a chromosome disorder the commonest is Down’s syndrome (mongolism) which affects one baby in every 600 and 2 or 3 per cent of all babies born to mothers aged 40 or more. Caused by an extra chromosome, mongolism produces visible abnormality and stunts mental development. IQ ranges from 33 to 70 (average IQ is 100) and mongol children cannot think in symbols as ordinary people do.

---Two important inherited conditions impair the brain by interfering with metabolism. Each involved lack of an enzyme needed to help the body use compound found in certain foods. About one per cent of mentally retarded people suffer from phenylketonuria. Lacking the enzyme phenylalanine hydroxylase, they cannot use the amino acid phenylalanine in ordinary protein. Accordingly, this substance builds up in the blood, damaging the brain. Similarly, sufferers from galactosemia cannot digest galactose, a sugar found in milk. Luckily most babies with these two conditions are spared mental disability if given diets that exclude the substances their bodies cannot metabolise.

---Doctors can often predict the chances of having a badly brain-damaged baby. Some women at risk avoid pregnancy or have abortions rather than give birth to individuals forever needing care. In fact, only a quarter of those born mentally retarded need lifelong care. Given sufficient help and stimulation, the rest can learn self-care and useful tasks, performed in sheltered workshops.

Congenital Disorders

---These include cerebral palsy, hydrocephalus and Down’s syndrome. Phenylketonuria and galactosemia are metabolic diseases which may result in brain damage. In most of these new born baby shows no external signs of abnormality. Cerebral palsy arises as a result of insufficient oxygen or glucose reaching the brain during birth. Babies with this either move stiffly and with difficulty or exhibit unnatural body movements. Hearing is often impaired.

---Hydrocephalus is the excess accumulation of cerebrospinal fluid in the brain. Babies born with this tend to have a larger than normal head.

---Phenylketonuria and galactosemia are genetically determined abnormalities of the metabolism that result in mental retardation. Until the baby is old enough for this to become apparent, there are no obvious signs and for this reason, it is important that babies undergo biochemical tests soon after birth.

Down Syndrome--->Next

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