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PubMed1998

Correlation of brain CT findings and developmental outcome in patients with spastic cerebral palsy.

Brain computed tomography (CT) is a useful tool for evaluating the pathologic findings in the brains of children with neurologic abnormalities. Brain CT investigation and the Münchner Funtionelle Entwicklungs Diagnostik (MFED) developmental assessment was performed in 88 patients with spastic cerebral palsy. The incidence of abnormal brain CT findings in patients with spastic cerebral palsy was 69.3%. The group with pathologic CT findings had a greater possibility of having developmental delay than the group with normal CT findings (p < 0.05). However, there was no significant relationship between the specific MFED categories and the types of brain CT abnormalities. Pathological CT findings could offer important prognostic information indicating a higher risk concerning the grade of developmental delay.

Adolescent↗

PubMed2000

Septo-optic dysplasia plus: a spectrum of malformations of cortical development.

The authors describe three children with septo-optic dysplasia (SOD)-plus: SOD and an associated malformation of cortical development. All three children had developmental delay, and two of the children had significant associated motor deficits. The associated cortical malformations with SOD include a spectrum of disorders of neuronal organization, not limited, as previously described, to schizencephaly. SOD-plus should be suspected in children with SOD and developmental delay.

Abnormalities, Multiple↗

PubMed2001

Risk factors associated with infantile spasms: a hospital-based case-control study in Taiwan.

We investigated the risk factors associated with infantile spasms (IS) by a hospital-based case-control study in Taiwan. Twenty-five patients with IS were recruited from one medical center (National Taiwan University Hospital) between 1990 and 1997. Based on a close-structured questionnaire, standardized interviews were carried out to obtain information on risk factors associated with IS. Two comparison groups are used, including a total of 106 subjects in the Disease Control group, and 139 subjects in the Normal Control group. Unconditional logistic regression is used to calculate odds ratios (OR) and 95% confidence interval (CI). Univariate analysis revealed gestational age, congenital cerebral anomalies, tuberous sclerosis (TS), asphyxia, febrile seizure, and developmental delay (before onset of spasm) were at increased risk of IS. After adjustment of multiple risk factors through unconditional logistic regression, significant risk factors for IS include congenital cerebral anomalies, TS, asphyxia, postterm, and developmental delay were highly associated with IS. The risk factors of IS may closely relate to underlying neurological abnormalities. Our results are consistent with the previous findings.

Brain Diseases↗

PubMed2004

Relative fitness of Cry1A-resistant and -susceptible Helicoverpa armigera (Lepidoptera: Noctuidae) on conventional and transgenic cotton.

Glasshouse and laboratory experiments were conducted to evaluate the relative fitness of Cry1A-susceptible and laboratory-selected resistant strains of Helicoverpa armigera (Hübner). Life history parameters of H. armigera larvae feeding on young cotton plants showed a significant developmental delay of up to 7 d for the resistant strain compared with the susceptible strain on non-Bacillus thuringiensis (Bt) cotton. This fitness cost was not evident on artificial diet. There was no developmental delay in the F1 hybrid progeny from the reciprocal backcross of the resistant and susceptible strains, indicating that the fitness cost is recessive. In two cohorts tested, survival to pupation of resistant larvae on Bt cotton expressing Cry1Ac was 54 and 51% lower than on non-Bt cotton, whereas all susceptible and F1 larvae tested on Cry1Ac cotton were killed. Mortality of susceptible larvae occurred in the first or second instar, whereas the F1 larvae were able to develop to later instars before dying, demonstrating that resistance is incompletely recessive. The intrinsic rate of increase was reduced by >50% in the resistant strain on Cry1Ac cotton compared with the susceptible strain on non-Bt cotton. There was a significant reduction in the survival of postdiapausal adults from the resistant strain and the F1 strains, indicating that there is a nonrecessive overwintering cost associated with Cry1A resistance in H. armigera.

Animals↗

PubMed2005

Anomalies associated with failed methotrexate and misoprostol termination.

BACKGROUND: Methotrexate and misoprostol are frequently used in combination for medical termination of pregnancy. Despite their frequent use, published information about low-dose exposures to these known teratogens is sparse and neonatal follow-up data are limited. We present neonatal outcomes in three infants from two different women who had failed medical terminations with methotrexate and misoprostol. CASES: A young gravida 1, para 0, presented with intrauterine pregnancy complicated by first-trimester exposure to oral methotrexate and vaginal misoprostol. Ultrasonography determined that the fetus had intrauterine growth restriction and ventriculomegaly. The infant had growth and developmental delays. A young gravida 4, para 3-0-0-3, also presented after first trimester exposure to methotrexate and misoprostol, and was found to have a twin gestation. The infants were noted to have multiple congenital anomalies, growth restriction, and developmental delay. CONCLUSION: Even single doses of methotrexate and misoprostol used in medical termination of pregnancy can be associated with multiple congenital anomalies.

Abortion, Incomplete↗

PubMed1994

Lip closing pressure in disabled children: a comparison with normal children.

Lip functions play an important role in the oral stages of feeding. Lip closing is an important early motor act in food acquisition and is essential for controlling chewing and swallowing. To date, there have been few papers on the developmental aspects of lip closing strength when taking in food, especially with regard to disabled children. This investigation was designed to produce an ordinal scale of midline lip pressure measurements for a cross-sectional, age-grouped population of normal children. Developmental changes in lip pressure were then compared with those of two populations of disabled children. Pressure measurements were obtained with a strain gauge transducer that was embedded in a spoon during normal feeding. The study population consisted of 104 normal children ranging in age from 5 months to 5 years, 11 children who showed developmental delay (mean 4.5 years), and 10 children with cerebral palsy (mean 5.0 years). Lip pressure was found to increase steadily from 5 months to 3 years and to increase slightly from 3 to 5 years in the normal population. The developmentally delayed group and the cerebral palsied group produced lip pressures and coefficients of variation below those of the normal 1 to 2-year-old group.

Age Factors↗

PubMed1997

Lack of correlation between phenotype and genotype for the polymorphically expressed dihydropyrimidine dehydrogenase in a family of Pakistani origin.

Dihydropyrimidine dehydrogenase (DPD) is the initial and rate-limiting enzyme in pyrimidine catabolism. DPD deficiency is associated with an increased risk of toxicity in cancer patients receiving 5-fluorouracil (5-PU) treatment. DPD deficiency causes an inborn error of metabolism called thymine-uraciluria that is in some instances associated with convulsive disorders and developmental delay in children. We have studied the molecular mechanism accounting for DPD deficiency in a Pakistani pedigree having 2-year-old child with thymine-uraciluria and exhibiting some degree of motor impairment and developmental delay. A common splice mutation was found in the patient's dihydropyrimidine dehydrogenase (DPYD) gene that produces a mutant mRNA resulting in the complete lack of DPD protein and activity in lymphocytes and primary fibroblast. This trait segregated in the family following a typical Mendelian distribution. Surprisingly, the patient's brother also had thymine-uraciluria and was homozygous for the splicing mutation but was clinically asymptomatic. Sequence tagged sites (STS) linkage analyses within 5 megabases of telomeric and centromeric DNA surrounding the DPYD gene revealed no allelic polymorphism between the two brothers. These results suggest that DPD deficiency might not be the only cause of the more severe clinical phenotypes observed in certain thymine-uraciluria patients and that an incomplete correlation between phenotype and genotype is present in the population.

Child, Preschool↗

PubMed1988

Facial and neuroepithelial abnormalities in a neurological mutant with congenital hydrocephalus. A scanning electron microscope study.

This investigation was carried out to determine the early structural abnormalities of the cephalic region in a genetic mutant of the rat characterized by prenatal aqueductal stenosis and hydrocephalus. The appearance of hydrocephalic and control embryos was examined on days 13-15 of gestation, and the structure and organization of the neuroepithelium and basal lamina were studied using scanning electron microscopy. In addition to some overall developmental delay, hydrocephalic embryos were characterized by abnormalities of forebrain and midbrain development, and eye and external ear anomalies. There were also associated defects of the midfacial region. The lateral cell surface of the neuroepithelium reflected the developmental delay of hydrocephalic embryos, and failed to undergo the morphogenetic cell-shaping changes seen in control embryos. There were also variations in the number of lateral cell-cell specializations as well as regions of neuroepithelial disorganization and occasional herniation into the mesenchymal compartment. The role of the neuroepithelial basal lamina and extracellular matrix in the development of these defects is considered.

Animals↗

PubMed1986

Comparative anatomical analysis of human trisomies 13, 18, and 21: I. The forelimb.

Human trisomies 13, 18, and 21 exhibit specific neuromuscular phenotypes (Pettersen and Bersu, '82) which include a high proportion of neuromuscular forelimb variations, many of which are atavistic in nature (de Beer, '58; Barash et al., '79; Aziz, '81a). In order to test the neuromuscular phenotype, examine the atavistic nature, and analyze the developmental delay of the trisomy forearm musculature, we dissected the forelimbs of five trisomy 13, ten trisomy 18, and two trisomy 21 cases. Our dissections compare favorably with the existing published trisomy cases (Opitz et al., '79; Pettersen and Bersu, '82). Additionally, we found significant differences in the stage at which developmental arrest occurred in trisomies 13 and 18 for the pectoral complex, extensor digitorum profundus, and intrinsic hand musculature. Some of these muscles, which occur normally in nonhuman primates (Cihak, '67, '69; Dunlap et al., '85), also appear briefly in normal human ontogeny (Cihak, '72), constituting further evidence for developmental delay in aneuploids. The disproportionately effected limb tissues also lend support to the evidence for some degree of autonomy in their development in normal individuals. Our observations are consistent with Shapiro's amplified developmental instability model ('83). Aneuploids may be viewed as genetic variants from which much may be learned about normal limb development, how aneuploidy affects dysmorphogenesis, and the kind of information which exists on the duplicated (or monosomic) chromosome.

Adult↗

PubMed1991

A method for obtaining a pure population of t6/t6 mouse embryos prior to developmental arrest.

Developmental delay, as the result of ovariectomy, causes mouse blastocyst embryos obtained from +/t6 inter se matings to separate into two distinct populations when placed into outgrowth medium. One population remains as free floating embryos for a significantly longer period of time than the other population. Based upon their phenotypic expression following attachment and outgrowth, the former population was considered to be composed entirely of t6/t6 embryos and the latter, to be composed of +/+ and +/t6 embryos (Nadijcka et al., '81). In the present study, two-dimensional gel electrophoresis identified the embryos which were delayed in attachment as t6/t6 embryos since they synthesize only p63/6.9a, a product of the Tcp-1a locus which is unique to t-haplotypes. The early attaching embryos, assumed to be +/+ and +/t6, synthesize both p63/6.9a and b. The p63/6.9b protein is coded for by Tcp-1b on the wild-type homologous chromosome. Control +/+ blastocyst embryos synthesize only p63/6.9b. The data show that t6/t6 embryos can be identified prior to their lethal period and, thus, subjected to comparative studies to determine the cause of their lethality. Developmental delay is the first method established to enable one to unambiguously identify t6/t6 embryos prior to developmental arrest.

Animals↗

PubMed1998

[Prognosis after perinatal asphyxia in full-term infants. A literature review].

Reviewing the literature published during the last 30 years we found comparable systematic studies of outcome for 1042 term infants born alive after likely intrapartum hypoxia-ischaemia. Fifty-two percent had no sequelae, 8% had developmental delay without associated handicaps, 4% had a single handicap, 11% were multihandicapped and 14% were dead as a consequence of the intrapartum hypoxia-ischaemia. The frequency of single handicaps exceeded the frequency found among the controls and in population studies. The frequency of children with developmental delay did not differ from that found among the controls. Outcome is closely related to the severity of hypoxic-ischaemic encephalopathy in the newborn.

Asphyxia Neonatorum↗

PubMed1988

Epidemiologic characteristics of cytomegalovirus infection in mothers and their infants.

In this longitudinal study of cytomegalovirus in 4578 pregnant women of middle/upper socioeconomic status in Houston, 52% had cytomegalovirus antibody when enrolled, and 48% were serologically susceptible. Studies were completed on 3899 mothers and their infants; 2.2% of these women experienced primary cytomegalovirus during pregnancy and 24% of those with primary infection transmitted cytomegalovirus to their infants. Of 22 cytomegalovirus-infected infants, 2 had disease at birth and 20 were asymptomatic. One symptomatic infant (primary maternal infection) has developmental delay. The other (immunocompromised mother with cytomegalovirus antibody before pregnancy) had hepatitis but has no symptoms at 1 year of age. On follow-up, 4 of 16 infants asymptomatic at birth have sequelae (hearing loss in 3, developmental delay in 1). All four were born to mothers with primary cytomegalovirus infection. Infant outcome was not related to trimester of maternal infection.

Antibodies, Viral↗

PubMed2001

[Cerebellar vermis hypoplasia with extracerebral involvement (retina, kidney, liver): difficult to classify syndromes].

UNLABELLED: Congenital cerebellar vermis hypoplasias diversely associated with retinopathy, nephropathy and hepatopathy are rare syndromes of uncertain nosology. We report three new cases. CASE REPORTS: Case 1. A 3-month-old boy presented a brief nystagmus. At the age of 2 years, he had facial dysmorphia, hypotonia, ataxia, ocular motor apraxia and neurodevelopmental impairment with cerebellar vermis hypoplasia. The electroretinogram showed asymptomatic retinal involvement. At the age of 6 years, he developed chronic renal failure. The diagnosis of familial juvenile nephronophthisis was made by detection of a large homozygous deletion of the NPH1 region. Case 2. A term newborn boy presented apnea, tachypnea, hypotonia, nystagmus, ptosis, lack of visual contact and hepatomegaly. He had facial dysmorphia, bilateral optic coloboma with chorioretinal dysplasia and cerebellar vermis hypoplasia. There were cysts in the kidneys with increased echogenicity and lack of demarcation between the pyramids and the cortex. The liver was hyperechoic with fibrosis. At the age of 15 months, the child had severe developmental delay. He had bouts of fever. A search for a large homozygous deletion of the NPH1 region was negative. Case 3. A term newborn girl presented difficulty to suck, cyanosis, hypotonia and ptosis. Later, the child had a developmental delay. At the age of 6 years, she developed chronic renal failure (nephronophthisis). At the age of 23 years, she presented divergent strabismus, ataxia, mental retardation, slow ocular pursuit and facial dysmorphia. The neuroimaging showed a cerebellar vermis hypoplasia. A search for a large homozygous deletion of the NPH1 region was negative. CONCLUSION: The diagnosis of cerebellar vermis hypoplasia requires searching for retina, kidney and liver involvement. The large homozygous deletion of the NPH1 region has to be investigated if typical familial juvenile nephronophthisis is associated. Because cerebellar vermis hypoplasia with extracerebral involvements (retina, kidney, liver) is part of many different closely related syndromes, a clear molecular classification is necessary for accurate genetic counselling and an early prenatal diagnosis.

Abnormalities, Multiple↗

PubMed2001

The infant who is visually unresponsive on a cortical basis.

OBJECTIVE: To further explain cortical abnormalities in infants without visually guided behaviors with anatomically normal eyes by using a battery of objective visual tests and neuroimaging studies. DESIGN: A cohort study. PARTICIPANTS: Thirty-one infants with clear ocular media and normal fundi, who were visually unresponsive by clinical examination, and 31 control subjects. METHODS: Full clinical examinations including Teller Acuity Cards (TAC) and developmental assessment. Infants with reduced acuities and/or developmental delay underwent pattern visual evoked potential (VEP) testing and brain neuroimaging studies. Eye movement recordings were done in individual infants. MAIN OUTCOME MEASURES: Visual acuity, VEPs, eye movement recordings. RESULTS: Infants were separated into two groups on the basis of being developmentally normal (DN) or developmentally delayed (DD). Fourteen DN infants had normal acuities for age and three of three infants had normal VEPs. On the basis of having normal visual function, these infants were considered to have visual inattention (VI). Sixteen DD infants had acuities ranging from normal to no visual orienting to the low vision TAC. All 16 DD infants had abnormal VEPs and abnormal neuroimaging studies (brain computed tomography, magnetic resonance imaging, or both) or microcephaly. On the basis of having structural and functional abnormalities of the brain, these infants were diagnosed as having cortical visual impairment (CVI). One additional infant with DD failed to orient to TACs but had a normal VEP and normal magnetic resonance imaging. In this infant and two infants with CVI the inability to "fix and follow" was attributed completely or partially to an oculomotor apraxia (OMA), which was confirmed by eye movement recordings. CONCLUSIONS: The infant who is visually unresponsive on a cortical basis has either VI or CVI. Infants with OMA can also seem to be visually unresponsive. These disorders can be delineated in infancy on the basis of developmental status and a unique set of responses to visual acuity, VEPs, and oculomotor testing.

Brain Diseases↗

PubMed1992

Language development after unilateral brain injury.

This longitudinal study describes the growth of syntactic abilities and vocabulary size in nine children with unilateral antepartum or perinatal brain injury. Five children with left hemisphere damage (LHD) and four with right hemisphere damage (RHD), ages 15 to 48 months, were evaluated on three or more occasions. Language samples generated from parent-child interaction were transcribed, coded, and analyzed using the Child Language Data Exchange System. Individual growth trajectories were constructed by graphing three dependent variables--MLU, scores on the Index of Productive Syntax (IPSYN), and number of different words--as a function of the child's age. One subject remained in a prelinguistic stage throughout the study. Simple linear functions best described the growth of MLU, IPSYN scores, and vocabulary in the other eight children. The slopes of the individual growth trajectories, the graphic representations of rates of progress, were comparable in the eight children. Seven children showed developmental delays in initial word use and five in the onset of multiword utterances. However, by age 24 months, four children with LHD and two children with RHD had syntactic capabilities comparable to those of children without brain injuries. The developmental patterns suggested that both cerebral hemispheres may play critical roles in the very earliest stages of language acquisition. Some unilateral lesions caused little discernible effect on language outcome in the toddler-preschool years after the initial developmental delays.

Brain Damage, Chronic↗

PubMedDate not supplied

Developmental trends and behavioral styles in very low birth weight infants.

The purpose of this study was to gather information about the characteristics of the very low birth weight baby. Twenty-six infants were involved in the study. Their mean gestational age was 29 weeks; mean gestational age was 29 weeks; mean birthweight was 1,170 grams. At the time of the study, the chronological age when corrected for prematurity was 7.9 months. During a home visit, the Denver Developmental Screening Test, the Infant Temperament Questionnaire, and the Home Observation Measurement Evaluation Inventory were completed. Pearson product moment correlation, chi square, and t-tests were used to analyze the data. Of the infants, 42 percent were at risk for developmental delays when assessed at the corrected gestational age. The infants were significantly more difficult as measured by the Infant Temperament Questionnaire. There was a moderate relationship between difficultness and childrearing environments. The findings of this study suggested that very low birth weight infants have an increased risk for developmental delays and are apt to have difficult behavioral styles. There was a negative relationship between infants with difficult behavioral styles and maternal involvement and responsivity.

Behavior↗

PubMed1999

Molar tooth sign in Joubert syndrome: clinical, radiologic, and pathologic significance.

Joubert syndrome is a rare autosomal-recessive condition characterized by early hyperpnea and apnea, developmental delay, and truncal ataxia. We previously described key ocular motor signs in Joubert syndrome and the molar tooth sign resulting from dysplasia of the isthmic segment of the brain stem, superior cerebellar peduncles, and vermis. In this study, we obtained clinical and developmental data in 61 cases, and radiologic data in 46 of these, to determine the prevalence of the molar tooth sign in a large sample, and to ensure that magnetic resonance images obtained for study were representative of the Joubert syndrome population at large. We studied the morphology of the isthmic segment of the pontomesencephalic junction, the segment of the brain stem derived from the primitive isthmus. Portions of the cerebellum analyzed included the superior cerebellar peduncles, the anterior and posterior lobes of the vermis, and the flocculonodular lobe. In one case, autopsy of the brain was performed. The average age at diagnosis was 33 months. All patients were hypotonic and developmentally delayed. The molar tooth sign was present in 85% of cases with 13% of these showing additional malformations. All patients without the molar tooth sign had other mimicking conditions such as neocerebellar dysgenesis, isolated vermian atrophy, cerebellar aplasia, and cystic dilation of the cisterna magna. Autopsy showed aplasia of the cerebellar vermis with dysplasia of the dentate nucleus, elongated locus coeruleus, and marked dysplasia of the caudal medulla. A better understanding of the clinical, radiologic, and pathologic features of Joubert syndrome should help uncover the genetic basis for the syndrome.

Abnormalities, Multiple↗

PubMed1998

MRI findings in a patient with partial monosomy 10p.

Partial monosomy 10p is a rare chromosomal disorder characterised by frontal bossing, micrognathia, congenital heart defects, vesicoureteral abnormalities, and developmental delay. This is the first report to describe seizures not associated with hypocalcaemia, as well as cortical atrophy and decreased white matter volume on magnetic resonance imaging, in a patient with documented partial monosomy 10p. The neuroradiographic abnormalities found in this patient provide a first step towards understanding the aetiology of the developmental delay and ventriculomegaly associated with this chromosomal abnormality.

Atrophy↗