cerebral palsy wid micocephaly with FTT probable etiology could be prematurity related periventricular leucomalacia...
history of preterm delivery. apart from torch infections, mri brain should be done to see for periventricular leukomalacia or perinatal injury. treatment physiotherapy, stimulation and proper dietary supplementation. fundus examination. muscle relaxation can be achieved via drugs if tone increased.
do torch profile of mother and baby, mri brain of baby. if cause of cerebral palsy is perinatal insult, proper follow up of mother during pregnancy and preferably institutional delivery for care of child after birth can ensure normal baby. 1st identify the cause.
microCephaly...most probably d/t tORCH group infections but Toxoplasmosis cause Macrocephaly evaluate whether PDA d/t Rubella m/c cause is CMV.. if CT Scan show periventricular calcification,lissen cephaly t/t GANCYCLOVIR
Microcephaly. Rubella virus infection in pregnancy. CMV infection in pregnancy. Toxoplasmosis in pregnancy . Phenyntoin drug in pregnancy. All these are causes for microcephaly.
thanks for yous opinion problem is next pregnis for this coupl is possibl or not what is rx for healthy child
some neurodegenerative diseases..most likely cerebral palsy need full history n evaluation
Treatment of cerebral palsy is physical therapy & Stem cell therapy.
Zika virus infection.... Microcephaly..??? Give opinions.. Plz
Torch infection or zika virus infection in pregnancy
Cases that would interest you
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I'm sharing an article on the Manifestations of Zika virus in the eye which I came across recently. This is something which should be useful to all Ophthalmologists. Ophthalmologists find retinal bleeding, abnormal blood vessel development and lesions in infants born to mothers who showed signs of the viral infection during pregnancy Researchers studying babies with a Zika virus-related birth defect say they have found previously unreported eye problems possibly linked to the virus that could result in severe visual impairment. In three Brazilian infants with microcephaly, the researchers observed retinal lesions, hemorrhaging and abnormal blood vessel development not noted before in relation to the virus. Zika virus is now known to cause microcephaly, a birth defect marked by smaller head and brain size. In Brazil, the site of the most serious outbreak, nearly 1.5 million people reportedly have the virus. Some 4,000 infants were recently born with microcephaly, according to reports. As a result, the World Health Organization declared a public health emergency in February, bringing added urgency to the need for more research. A prior study of 29 Brazilian babies with presumed congenital Zika infection showed that a third had eye problems. These included ocular lesions, optic nerve abnormalities and chorioretinal atrophy, a withering of the retina and choroid, the latter of which provides oxygen and nutrients to the retina. For this case study, ophthalmology researchers from Brazil and Stanford University examined the eyes of three infant boys from Northern Brazil born in late 2015 with microcephaly. All had mothers with suspected Zika virus infections during the first trimester of pregnancy. Among the findings, the researchers identified several types of ocular issues not previously observed in relation to Zika virus, some of which could cause severe visual impairment if untreated. These included: • Hemorrhagic retinopathy, or bleeding in the retina, the light-sensitive layer of cells lining the back of the eye; • Abnormal vasculature in the retina, including signs of missing blood vessels in the retina where the cells may have died; and • Torpedo maculopathy, identified by torpedo-shaped lesions in the macula, the central portion of the retina. While retinal lesions have been observed in prior papers on Zika-related ocular findings, the authors note that this type of lesion has not been observed in cases of microcephaly. In addition to these observations, the infants in this study also exhibited other ocular symptoms noted in the previous study. Specifically, all three babies in this case study showed signs of pigmentary maculopathy, lesions that appear as speckles of pigment on the macula. Four eyes had symptoms of chorioretinal atrophy marked by a darkly pigmented ring. The study is small with limited observational data. However, the findings add to a growing body of clinical information about how the Zika virus may affect children’s eye development and vision. The authors noted that it remains unclear whether the viral infection itself causes eye abnormalities or if they are a consequence of Zika-induced microcephaly. “To my knowledge, the eye problems we found have not been associated with Zika virus before,” said Darius Moshfeghi, M.D., senior author and a professor of ophthalmology at the Stanford University School of Medicine. “The next step is to differentiate what findings are related to the Zika virus itself versus microcephaly caused by the virus in order to better understand which infants will need screening.” For now, the authors are calling for all babies with microcephaly in areas hit by Zika to be examined by an ophthalmologist. This is consistent with recent screening recommendations made by the Centers for Disease Control and Prevention. "Until further notice, health professionals in regions endemic for Zika infection are advised to submit all newborns with microcephaly to retinal examinations," the authors wrote. "The procedure can contribute significantly to our understanding of the infection." Potential Eye-Related Manifestations The mild course of disease can include nonpurulent conjunctivitis. In Brazil, investigators have reported macular and optic nerve abnormalities in a study of 29 infants with microencephaly due to a possible Zika congenital infection,3 and in an earlier study of 3 infants.4 The findings included gross macular pigment mottling, macular chorioretinal atrophy, optic nerve hypoplasia, increased cup-to-disc ratio, iris coloboma, and lens subluxation. Another study described additional ocular findings of vascular changes, hemorrhagic retinopathy and torpedo maculopathy.5 It is not known if these ocular findings are a direct result of the Zika virus infection or are a consequence of microcephaly. Role of Ophthalmologists The CDC encourages all healthcare providers to report suspected cases of Zika virus infection to their state health department to help reduce the risk of local transmission. CDC recommends that as part of an examination of all patients with possible congenital Zika virus infection, an eye examination be performed, including a retina evaluation, either in the hospital or within one month after birth. This is from another article on the subject: Retinal Manifestations of ZIKV A mild course of the disease can include anterior uveitis and a non-purulent conjunctivitis.14 Dr. Ventura and colleagues published the first report of three children with presumed ZIKV congenital infection and ocular abnormalities.They identified retinal alterations such as pigment mottling and chorioretinal atrophy in the macular region of the infants. Further studies in two cities in northeast Brazil, Recife and Salvador, reported similar ocular abnormalities affecting the retina as well as optic disc abnormalities in these infants. These findings included gross macular pigment mottling, macular chorioretinal atrophy, optic nerve hypoplasia, increased cup-to-disc ratio, iris coloboma and lens subluxation. In a study conducted in Recife, nine of 20 eyes (45 percent) had optic nerve hypoplasia, pallor and increased cup-to-disk ratio.11 The pathophysiology of these lesions in these infants is thought to be related directly to the virus or an associated toxin leading to an inflammatory reaction. In addition, this same mechanism could be responsible for the severe cerebral findings, such as abnormal development and cerebral calcification. Dr. Ventura and colleagues hypothesized that ZIKV may cause more severe ocular abnormalities when the infection occurs in the first or second trimester of pregnancy, as it does in other congenital infections such as toxoplasmosis, rubella and cytomegalovirus. Furthermore, other unknown factors, such as the amount of virus in the circulation and the immunologic response of mother and/or fetus, may play an important role in the formation of these abnormalities in newborns.Dr. Arun Rajan4 Likes2 Answers
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NEW INSIGHTS INTO HOW THE ZIKA VIRUS CAUSES MICROCEPHALY. June 1, 2017. A STUDY published today in Science SHOWS that the ZIKA VIRUS HIJACKS A HUMAN PROTEIN CALLED Musashi-1 (MSI1) TO ALLOW IT TO REPLICATE IN, AND ILL, NEURAL STEM CELLS. Almost all MSI1 protein in the developing embryo is produced in the neural stem cells that will eventually develop into the baby's brain, which COULD EXPLAIN WHY THESE CELLS ARE SO VULNERABLE TO ZIKA. SINCE 2016 THOUSANDS OF CHILDREN ACROSS SOUTH AMERICA have been BORN WITH MICROCEPHALY, which causes abnormally small heads, AFTER THEIR MOTHERS became INFECTED WITH the ZIKA virus DURING PREGNANCY. The OVERLAP BETWEEN ZIKA cases IN PREGNANT WOMEN AND an increase in babies born with MICROCEPHALY STRONGLY SUGGESTED THAT the VIRUS TARGETS STEM CELLS in the developing human brain, BUT WHY AND HOW has REMAINED A MYSTERY. TODAY'S STUDY IS THE FIRST TO ASSOCIATE MSI1 WITH MICROCEPHALY AND THE ZIKA VIRUS. Dr Fanni Gergely from the University of Cambridge said: "The DEVELOPMENT OF a healthy HUMAN BRAIN IS an incredibly COMPLEX PROCESS that RELIES ON STEM CELLS AND the coordinated actions of MANY GENES. We've shown for the first time this interaction between ZIKA AND MSI1 - with MSI1 GETTING EXPLOITED BY THE VIRUS for its own destructive life cycle, turning MSI1 into the enemy within. We hope that in the future THIS DISCOVERY COULD LEAD TO WAYS OF GENERATING POTENTIAL ZIKA VIRUS VACCINES." Dr Mike Turner, Head of Infection and Immunobiology at Wellcome said: "This is the FIRST STUDY TO SHOW a CLEAR LINK BETWEEN A SPECIFIC PROTEIN, THE ZIKA VIRUS AND MICROCEPHALY. This new finding really helps to explain why neural stem cells are so vulnerable to Zika infection and I hope this can be a first step in determining how we could stop this interaction and disease. It will also be INTERESTING TO INVESTIGATE whether this protein is involved in other viruses, such as RUBELLA, that can ALSO ACCESS AND IMPAIR THE DEVELOPING HUMAN BRAIN." Researchers from the University of Cambridge studied a variety of cell lines, including human neural stem cells, to investigate how Zika virus infection can lead to microcephaly. They suspected that MSI1 - AN RNA BINDING PROTEIN - might be important in this process because it is involved in regulating the pool of neural stem cells that are required for normal brain development. The RESEARCHERS SHOW that when the ZIKA VIRUS ENTERS these STEM CELLS, it HIJACKS MSI1 FOR ITS OWN REPLICATION AND DAMAGES THE CELLS IN AT LEAST TWO WAYS. FIRSTLY, MSI1 binds to the Zika virus genome allowing it to replicate and making the cells more vulnerable to virus-induced cell death. When the researchers infected cells that had been rendered unable to produce MSI1, virus replication was significantly reduced, as was cell death, indicating that the presence of MSI1 is required for efficient Zika replication. SECONDLY, they showed that MSI1 ALSO DISRUPTS the NORMAL DEVELOPMENT PROGRAMME OF NEURAL STEM CELLS. In cells infected with Zika virus MSI1 BINDS TO the VIRUS GENOME in favour of its normal targets in the cell. The VIRUS essentially acts like a 'sponge', PREVENTING MSI1 ARE CRUCIAL FOR NORMAL NEURAL DEVELOPMENT, ARE LOST, LEADING TO MICROCEPHALY. TO CONFIRM that MSI1 IS IMPORTANT to grow a normal size brain, the SCIENTISTS DEMONSTRATED that MSI1 IS MUTATED IN INDIVIDUALS WITH A RARE TYPE OF INHERITED MICROCEPHALY (AUTOSOMAL RECESSIVE PRIMARY MICROCEPHALY) UNRELATED TO ZIKA INFECTION. These RESULTS COLLECTIVELY SUGGEST THAT NEURAL STEM CELLS NEED MSI1 TO GENERATE ENOUGH NEURONS FOR NORMAL BRAIN SIZE, BUT the PRESENCE OF MSI1 ALSO INCREASES the VULNERABILITY OF THESE CELLS TO ZIKA INFECTION, LEADING TO the DEATH OF the POPULATION which ULTIMATELY RESULTS IN MICROCEPHALY. $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ MORE INFORMATION: DOI: 10.1126/science.aam9243 P. Chavali el al., "Neurodevelopmental protein Musashi 1 interacts with the Zika genome and promotes viral replication," Science (2017). http://science.sciencemag.org/lookup/doi/10.1126/science.aam9243 ____________________________________ PROVIDED BY: Wellcome Trust. ____________________________________ IMAGE : Musashi-1 protein is generated in large quantities by neural stem cells of the developing human brain. Chevali et al. find that the presence of Musashi-1 greatly increases production of Zika virus, making neural stem cells particularly vulnerable to cell death following viral infection. Loss of this irreplaceable cell population results in MICROCEPHALY, which is common in Zikaexposed babies. CREDIT: Generated by the Gergely lab *******************************+***************************Dr. Puranjoy Saha16 Likes8 Answers
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A case of 4 month old child -delayed milestones, microcephaly, craniosynostosis due to premature fusion of sutures. mngNida Fathima2 Likes16 Answers
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a11 months old male baby came to pediatric with fever and mother reaveld delayed devlopment whats the dx and managementDr. Gopikrishna Pallalac1 Like8 Answers
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Good morning revered doctors on Curofy. Posted below are educational slides on reemerging infection ZIKA. Thank you.Dr. Kazi Wajid Husain14 Likes8 Answers