[Growth disorders of the eyelashes].
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Magnetic resonance imaging reveals the anatomy of the pituitary and hypothalamus with unique detail. The clinical and biochemical investigation of short stature in childhood may be difficult and complex; magnetic resonance imaging of the pituitary is a non-invasive technique which can help to clarify the diagnosis of growth hormone insufficiency and to determine its cause. Most cases of growth hormone insufficiency have previously been considered to be idiopathic; in about 60% of these children, magnetic resonance imaging shows a characteristic structural abnormality which has been termed pituitary stalk interruption syndrome. The most important role of magnetic resonance imaging is in the diagnosis of destructive lesions of the hypothalamic-pituitary axis which may initially present with growth failure.
The growth and development of a child is a mirror of his living conditions and health. For decades pediatricians have been trying to achieve an earlier identification of children with growth disorders. The measures of prevention in Germany have not been successful so far. Diagnosis for example of GH-deficiency to ensure optimal substitution with growth hormone is usually not early enough. A screening system using an auxological data bank for growth disorders has been set up by us recently. Since 1998 we have collected height and weight measurements in relation to age and sex from patients cared for by a large number of pediatricians in the region of Leipzig, Germany. By september 1999, 30,182 children of different ages have been screened. The system identifies children with short stature below the 3. centile and tall stature above the 97. centile of the German Synthetic Normcurve (Hermanussen/Burmeister 1999). In 6.81% of the children a growth disorder was identified (3.03% above 97. and 3.78% below 3. centile). In 54 cases (0.18%) we found a pathological reason for short or tall stature. A sensitive screening system has been set up for the early detection of growth disorders and obesity in childhood. We generate a data pool for multiple questions in research of human growth. We will generate yearly reports for the development of new strategies in preventive medicine.
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BACKGROUND: Growth retardation is common in children with cerebral palsy. This may in part be due to the cerebral injury, but insufficient nutrition may also play a role. The aim of the present study was to estimate the prevalence of feeding problems, growth retardation, underweight and overweight in children with cerebral palsy. MATERIAL AND METHODS: Population-based study of children with cerebral palsy in two Norwegian counties. Information was obtained both from parents and from medical records. 154 children born between 1 January 1982 and 31 December 1996 were included in the study. RESULTS: 30% of the children had height below the 2.5th centile, 10% had weight for height below the 2.5th centile, and 7% were obese (weight above the 97.5th centile). 26% of the children had oral motor dysfunction and 33% were unable to self-feed. Although these problems were more prominent in children with severe forms of cerebral palsy, the results of the multivariate analyses suggested that lack of ability to self-feed was a significant independent risk factor for height growth retardation and underweight. Parents of 24 (15%) children reported that the family's quality of life was significantly impaired by the feeding problems of the child. INTERPRETATION: Our results are consistent with previous hospital-based studies and suggest that assessment of nutrition and growth should receive particular attention in the rehabilitation of children with cerebral palsy, in particular if the child is unable to self-feed.
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