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Query: UMLS:C0025362 (mental retardation)
 15,878 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The child that is slow to walk causes concern. When cerebral palsy, mental retardation and muscular dystrophy have been excluded, what remains? Thirty five children (19 boys and 16 girls) with hypermobile joints, blue sclera and bat ears (the 'lax ligament syndrome') were referred by general practitioners to a general paediatric outpatient clinic over two years. Three were referred in the first three months of life because of clicking hips; 14 children aged one to two years, had delayed milestones of motor development and exhibited bottom shuffling; 10 children aged four to five years presented with 'growing pains' or 'funny gait' and eight older children had multiple minor complaints. The lax ligament syndrome is a comparatively common mild collagenopathy. It may well come to light on routine surveillance in general practice. It is dominantly inherited and improves with time; management is therefore expectant and symptomatic. A firm and reassuring diagnosis can be given which saves both anxiety and investigations.
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PMID:Lax ligament syndrome in children associated with blue sclera and bat ears. 211 44

Drooling is a significant problem demonstrated by individuals of all ages with a variety of etiologies such as neurological disorders, cerebral palsy, mental retardation and others. Persistent drooling not only creates troublesome hygienic problems for patients, teachers, nurses, and playmates because of the constant soiling of clothes, toys, and work materials, but also causes an odor from their clothing and bibs. The older patient with normal cognition is disturbed by the drooling and may become depressed and reclusive. Successful management of drooling alleviates these problems, improves appearance and self-esteem and significantly reduces the time involved in the care of the sufferers. The author, who had studied at the University of Toronto for 2 years, acquired the technique of submandibular duct relocation under the guidance of Dr. Crysdale. We carried out the surgical procedure of submandibular duct relocation for drooling on six patients who had cerebral palsy. The surgical procedure resulted in a dramatic decrease in drooling and odor levels. All of them improved in appearance, and the time involved in the care of the suffers was significantly reduced. The complication of ranula, however, appeared in two cases, which suggested a much higher frequency than that in the report of Crysdale. It seems that a detailed explanation to parents and teachers about the advantages and disadvantages of submandibular duct relocation is important.
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PMID:[The management of drooling in patients with cerebral palsy--submandibular duct relocation]. 213 67

The incidence of major handicaps was studied in a selected high-risk population of 1919 very low birth weight (less than or equal to 1500 gm) infants born between 1976 and 1985. Seventy-four percent of these infants were discharged alive. We have handicap information on 632 infants who have been followed for up to 7 years of age; 462 were evaluated at 18 months or later. Patients lost to follow-up represent 55% of the eligible population, but inpatient morbidity factors were available for the entire population and were used to calculate synthetic estimates of handicap rates. The overall incidence of severe major handicaps at 18 months was 18.0% (83/462). Cerebral palsy was found in 7.6%, and 6.5% were mentally retarded (IQ less than or equal to 70). Severe retinopathy of prematurity was present in 5.5%, and 5.4% of the infants had neurosensory hearing loss. Thirty-one infants (6.7%) had more than one handicap, the most common combination being cerebral palsy and mental retardation. Outcome of infants grouped by 250 gm birth weight intervals was compared for two periods (1976 to 1980, and 1981 to 1985); the numbers of survivors in each birth weight group increased during the second period, especially in the 500 to 750 gm and the 751 to 1000 gm groups. The observed incidence of major handicaps decreased from the first 5-year period to the second 5-year period (p less than 0.001). The largest decreases in the observed proportion handicapped occurred in the two lowest birth weight groups. The incidence of multiple handicaps also dropped; again, the two lowest birth weight groups showed the largest decrease. We conclude that an increased survival rate of very low birth weight infants need not be associated with an increased incidence of major handicaps.
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PMID:Increased survival rate in very low birth weight infants (1500 grams or less): no association with increased incidence of handicaps. 182 23

The aims of the study were (1) to replicate previous quantitative studies of motor activity in low-risk and high-risk preterm infants and (2) to apply a new method of systematic analysis of the qualitative characteristics of general movements in these two groups of infants. Sequential one-hour videorecordings of the unstimulated infants in the incubator were made during the preterm period and then continued during the postterm period until about 20 weeks. The high-risk group consisted only of infants with signs of haemorrhage and/or leucomalacia in the repeated ultrasonograms of the brain. The neurological follow-up continued up to a minimum of one and a maximum of three years of corrected age. The quantification of the various motor patterns in 12 matched pairs of low-risk and high-risk preterm infants revealed a slight but significant (P = 0.05) excess of isolated arm movements in the low-risk cases during the activity phase. No other movement pattern differed significantly. The qualitative assessment of general movements during the preterm period resulted in all but one of the 14 low-risk cases having a normal quality of general movements. In the lesion-group (N = 29) all the infants had an abnormal quality during the preterm period. Eight cases later became neurologically normal although 1 of them had strabism. In addition, one infant was blind (ROP) and retarded and one other had mental retardation. Nineteen infants later developed cerebral palsy (two monoplegia of a leg, three hemiplegia, 5 diplegia and 9 quadriplegia). Strabism was present in 48.3% of the whole group of 29 cases. A semi-quantitative estimation of various aspects of the abnormal general movements made a typology of abnormal patterns possible. A graphic display of developmental trajectories of individual cases, depicting the course of abnormal aspects along the time axis, helps document the evolution of abnormal signs. Their course is a better predictor of the neurological outcome than the nature and localization of the lesion, detected by imaging techniques. The qualitative assessment of general movements from videorecordings is a reliable, quick, cheap and totally non-intrusive method in neonatology for the early detection of functional impairment of the nervous system.
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PMID:Qualitative changes of general movements in preterm infants with brain lesions. 225 80

The prevalence, causal origin of and impairments associated with severe mental retardation (SMR) were investigated among all school-age children (six to 13 years) living in the city of Bologna, Italy. 90 children (57 boys, 33 girls) with IQs less than or equal to 50 were identified. The prevalence of SMR was 4.2 per 1000 for males, 2.5 per 1000 for females and 3.4 per 1000 for both sexes. Causal origin was prenatal for 33.3 per cent, perinatal for 14.4 per cent, combined pre- and perinatal for 5.6 per cent and postnatal for 13.3 per cent. Another 12.3 per cent of the children with IQs less than or equal to 50 had autism or childhood psychosis, while there was no evident cause of mental retardation for the remaining 21.1 per cent. 50 per cent had at least one associated physical or neurological impairment other than mental retardation, with epilepsy and cerebral palsy predominating.
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PMID:An epidemiological study on severe mental retardation among schoolchildren in Bologna, Italy. 225 87

This paper presents some of the major advances that have occurred in the field of mental retardation over the past 30 years. Included in this list are the developments of cytogenetics, etiology of cerebral palsy, progress in prevention as in Tay-Sachs disease and phenylketonuria, the fragile X syndrome, and the influence of certain aspects of diet on the developing fetus. Also included is a discussion of some of the areas of management of persons with mental retardation which remain as challenging problems for the future. These include persons who are both mentally retarded and emotionally ill, persons who are in penal institutions, and persons who have familial mental retardation.
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PMID:Mental retardation, 1990: an overview. 229 Jan 7

To determine whether vaginally born breech infants are at increased risk for morbid events as compared with breech infants delivered by cesarean, we studied 1240 singleton breech infants without congenital anomalies delivered in Northern California Kaiser Permanente Medical Care Program hospitals during 1976-1977. Medical record review provided information on indications for method of delivery, delivery complications and injuries, neonatal complications, and neurologic sequelae up to 4 years of age. The relative risk estimates for asphyxia (1.0; 95% confidence interval 0.7, 1.4), head trauma (1.6; 95% confidence interval 0.2, 17.0), neonatal seizures (0.8; 95% confidence interval 0.1, 7.1), cerebral palsy (1.6; 95% confidence interval 0.2, 17.4), and developmental delay (2.0; 95% confidence interval 0.9, 4.4) for vaginally born compared with cesarean-delivered infants indicated that vaginally born infants were not at increased risk for these outcomes. We used multiple logistic regression to control for confounding variables. The adjusted relative risk estimate for the combined-outcome category of head trauma, neonatal seizures, cerebral palsy, mental retardation, or spasticity was 0.5 in vaginally delivered infants (95% confidence interval 0.1, 3.2). When all morbid outcomes were considered in combination, the adjusted relative risk estimate was 0.9 for vaginally delivered infants (95% confidence interval 0.6, 1.4).
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PMID:Morbidity among breech infants according to method of delivery. 232 65

We studied a case of Lesch-Nyhan syndrome with delayed onset of self-mutilation. Athetotic cerebral palsy and mental retardation were diagnosed at 1 year old, but the disease was not suspected until age 8 years when he began biting his lips and fingers. There was no obvious alteration of catecholamine in urine and CSF. We attempted to induce a series of blink reflexes by electric, mechanical and photic procedures. The R1 amplitude increased and the latency of the R2 shortened compared with controls. This shows that not only orbicularis motoneuron itself, but also uncrossed interneurons, are in a state of hyperexcitability. The contralateral R2 was poor which was in favour of hypoexcitability of the crossed interneurons at the brainstem. The significant large response was obtained by photic procedure which was in favour of hyperexcitability of the motoneurons. Therefore, it is demonstrated that a thorough examination of blink reflexes provides a useful method for examination of a state of the underlying neural activity.
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PMID:Lesch-Nyhan syndrome with delayed onset of self-mutilation: hyperactivity of interneurons at the brainstem and blink reflex. 232 43

In an epidemiological study of a county cohort of 4,138 liveborn children, surveyed at age four, 45 had disability (1.1%). The following period prevalences from birth to age four in per mille were found: motor handicap 5.1, to include cerebral palsy 4.1, myelomeningocele and hydrocephalus 0.5, and metabolic disorders 0.5; severe mental retardation 2.9, mild 1.4, subnormality 2.7; epilepsy 4.6; severe visual defect 1.4; severe auditory defect 0.7. Perinatal damage alone was likely in only three children out of 45. Two thirds had a prenatal cause or a combination of prenatal and perinatal causes. Birth asphyxia seemed to be a rare cause of motor disability and mental retardation. Prematurity per se gave a risk of spastic diplegia, but not of mental retardation. Among the mentally retarded, half were light for gestational age, and in more than half, the damage occurred prenatally.
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PMID:An epidemiological study of disability in 4-year-old children from a birth cohort in Frederiksborg County, Denmark. 234 71

The purpose of this population-based study on twins whose birth weight was discordant by 1.0 kg or more, was to evaluate the impact of abdominal delivery on the "corrected perinatal mortality" (fetal death prior to delivery being excluded), and also on childhood morbidity. Between 1973 and 1983, 277 such discordant twin pairs were identified in Sweden, using the Medical Birth Registry, Stockholm. The original medical records were retrieved for 267 pairs. The presence of childhood morbidity of 437 twins born between 1973 and 1980 was determined by means of questionnaires sent to rehabilitation centers for handicapped children, offices for the Provision of Care to the Mentally Retarded throughout Sweden, as well as to local Boards of Education. No association was found between corrected perinatal mortality figures and a more than 4-fold increase in cesarean section rate, from 11.4% during 1973-75 to 45.9% during 1980-83. The 10 perinatal deaths (1.9%) could be correlated with birth weight (9 small and 1 large twin; p = 0.01), but not to the mode of delivery of the smaller twins (6 born vaginally and 3 abdominally; p greater than 0.05). At follow-up, at the age of 8 years or more, 5 smaller and 4 larger twins had cerebral palsy and/or mental retardation; no correlation was found with mode of delivery. The results of this study show that perinatal death (twins with lethal malformation included) or residual major handicap occurred in one of ten pregnancies of twins with discordant birth weights. Abdominal delivery seemed to have little impact on either short or long-term outcome.
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PMID:Prognosis for twins discordant in birth weight of 1.0 kg or more: the impact of cesarean section. 234 29


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