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Very Small Head Size Could Signal Problems in Newborns

Last Updated: September 14, 2009.

Early screening urged for detection of epilepsy and other health issues, experts say.

MONDAY, Sept. 14 (HealthDay News) -- Children born with a much smaller-than-average head size are more likely to have neurological and cognitive problems, and should be screened for them, new guidelines suggest.

The guidelines, developed by the American Academy of Neurology and the Child Neurology Society, appear in the Sept. 15 issue of Neurology.

More than 25,000 children in the United States are born each year with microcephaly, defined as having a head circumference smaller than that of 97 percent of children. Microcephaly can also become apparent later, though usually by age 2, according to information in an academy news release.

While not a problem in and of itself, children with the condition are at higher risk of having epilepsy, cerebral palsy, cognitive delays, learning disabilities, mental retardation and eye and ear disorders, Dr. Stephen Ashwal, a child neurologist at Loma Linda University School of Medicine in California, explained in the news release.

"Forty percent of children with microcephaly also have epilepsy, 20 percent also have cerebral palsy, 50 percent also have mental retardation, and 20 to 50 percent also have eye and ear problems," Ashwal said.

"For these reasons, it is necessary for doctors to recognize microcephaly and check the child for these associated problems, which often require special treatments," said Ashwal, lead author of the guidelines. "This is an important recommendation, as it allows doctors to provide more accurate advice and counseling to families who have a child with microcephaly."

Screening using brain scans such as an MRI or CT scan may be called for, Ashwal said. Genetic testing may help determine the causes of microcephaly.

Even though a small head size may run in families, parents should still have their children screened for the other conditions. Pediatricians should also be told about a family history of neurological diseases, the researcher noted.

Not all children with smaller-than-average head sizes will go on to have health or learning issues. "It should be noted, though, that some children with small head size have normal development and do not develop any related conditions or problems," Ashwal stated.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on microcephaly.

SOURCE: American Academy of Neurology, news release, Sept. 14, 2009

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