All are associated with Fetal alcohol syndrome except: (AIIMS Nov 2009)
|D||Simian crease across the palm|
1. Most of the features of Fetal alcohol syndrome (FAS) are variable.
2. They may or may not be present in a given child. However, the most common and consistent features of FAS involve the growth, performance, intelligence, head and face, skeleton, and heart of the child.
3. Growth is diminished. Birth weight is lessened. Retardation of longitudinal growth is evident on the measurements of length in infancy and of standing height later in childhood. The growth lag is permanent.
4. Performance is impaired. The FAS infant is irritable. The older FAS child is hyperactive. Fine motor skills are impaired with weak grasp, poor eye-hand coordination, and tremors. Intelligence is diminished. The average IQ is in the 60s.
5. The head is small (microcephalic). This decrease may not even be apparent to family and friends.
6. It is evident upon comparison of the child's head circumference to that of a normal child on a growth chart.
7. The usual degree of microcephaly in FAS is classified as mild to moderate.
8. It is primarily due to failure of brain growth. The consequences are neither mild nor moderate.
9. The face is characteristic with short palpebral fissures, sunken nasal bridge, short nose, flattening of the cheekbones and midface, smoothing and elongation of the philtrum.
10. The skeleton shows characteristic changes; abnormal position and function of joints, shortening of the metacarpal bones leading to the fourth and fifth fingers, and shortening of the last bone (the distal phalanx) in the fingers.
11. There is also a small fifth fingernail and a simian crease across the palm.
12. A heart murmur is often heard due to an ASD or VSD.A number of other birth defects can occur in children with FAS. These include hydrocephalus, cleft lip (sometimes with a cleft palate), coarctation of the aorta, and meningomyelocele.
Ref: Nelson’s textbook of Peditrics, 18th edition, Vol. 1, Pg. 781