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What Do The Following Test Reports Of A 5 Month Old Baby Indicate?
Question: Hi Doctor,
This is in reference to my previous query I had posted.
Our baby boy is now 5 months 14 days old. He at times shakes his head from side to side as if saying No as gesture (left to right) He is able to turn his head to his right but not to the left. We noticed that movement of his right hand & leg are more compared to his left hand & leg. He doesnt have full head control yet. When we carry him on shoulders, he leans over our shoulder but not able to lift his head straight. However, when we put him on his stomach, he attempts to lift his head and can stay on for 3-5 seconds. Based on doctor's suggestion, we got BERA, blood and MRI tests done. Please find the reports attached. We are planning to meet Pediatric neurologist tomorrow. We have met physiotherapist meanwhile based on doctors advise and started physiotherapy as well. Please let me know your comments based on the reports and above said diagnosis.
This is in reference to my previous query I had posted.
Our baby boy is now 5 months 14 days old. He at times shakes his head from side to side as if saying No as gesture (left to right) He is able to turn his head to his right but not to the left. We noticed that movement of his right hand & leg are more compared to his left hand & leg. He doesnt have full head control yet. When we carry him on shoulders, he leans over our shoulder but not able to lift his head straight. However, when we put him on his stomach, he attempts to lift his head and can stay on for 3-5 seconds. Based on doctor's suggestion, we got BERA, blood and MRI tests done. Please find the reports attached. We are planning to meet Pediatric neurologist tomorrow. We have met physiotherapist meanwhile based on doctors advise and started physiotherapy as well. Please let me know your comments based on the reports and above said diagnosis.
Brief Answer:
Developmental therapy is the mainstay of treatment.
Detailed Answer:
Thanks for asking back once again.
I have gone through the attached reports. The BERA reports are fine and indicate no concern in terms of hearing. The MRI however indicates that there has been some damage. As of now there is hardly anything that can be done. You can feel free to consult a pediatric neurologist but it is not likely to offer much. The damage to brain explains the delayed milestone of head holding (should have been reached by 4 months of age). Physical therapy or developmental therapy is what is needed. A step by step approach will ensure proper and timely development and would limit development of disabilities. The steps you are taking at home, are proper.
Unless seizures occur you need not worry. In case of seizures the help of a pediatric neurologist would need to be sought.
Let me know if I could be of further assistance.
Regards
Developmental therapy is the mainstay of treatment.
Detailed Answer:
Thanks for asking back once again.
I have gone through the attached reports. The BERA reports are fine and indicate no concern in terms of hearing. The MRI however indicates that there has been some damage. As of now there is hardly anything that can be done. You can feel free to consult a pediatric neurologist but it is not likely to offer much. The damage to brain explains the delayed milestone of head holding (should have been reached by 4 months of age). Physical therapy or developmental therapy is what is needed. A step by step approach will ensure proper and timely development and would limit development of disabilities. The steps you are taking at home, are proper.
Unless seizures occur you need not worry. In case of seizures the help of a pediatric neurologist would need to be sought.
Let me know if I could be of further assistance.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
1. what is the possible reason for this damage 2. Will the damage get rectified over a period of time 3. Does this mean delay in development milestones? 4. Apart from development delays what are other possible issues that can arise 4. What care should be taken
Brief Answer:
Questions answered one by one.
Detailed Answer:
Thanks for writing back. Let me try to answer your queries one by one.
1. The MRI already mentions hypoglycemia as the possible cause of the injury. Often the newborn is unable to maintain blood sugar levels stably. The brain does not have any fuel stores and feeds on the glucose supply provided by the blood. A sudden drop in blood sugar therefore causes the brain to be out of fuel and this can lead to brain cells dying. This is what is meant by hypoglycemic injury.
2. The brain has a property called neuroplasticity by the virtue of which significant improvement in the lost functions can be expected. However, how much of it will occur is hard to predict.
3. Yes, this is the cause of developmental delay. Proper developmental therapy will ensure that the milestones can be reached effectively.
4. The brain controls everything. So if the brain suffers, the effect can involve practically any function. However, I would insist you not to unnecessarily worry.
5. Apart from neurodevelopmental evaluation and follow up (including developmental therapy and physical therapy) there is hardly anything more that needs to be done. Be sure to talk continuously with your baby.
Let me know if I could help further.
Regards
Questions answered one by one.
Detailed Answer:
Thanks for writing back. Let me try to answer your queries one by one.
1. The MRI already mentions hypoglycemia as the possible cause of the injury. Often the newborn is unable to maintain blood sugar levels stably. The brain does not have any fuel stores and feeds on the glucose supply provided by the blood. A sudden drop in blood sugar therefore causes the brain to be out of fuel and this can lead to brain cells dying. This is what is meant by hypoglycemic injury.
2. The brain has a property called neuroplasticity by the virtue of which significant improvement in the lost functions can be expected. However, how much of it will occur is hard to predict.
3. Yes, this is the cause of developmental delay. Proper developmental therapy will ensure that the milestones can be reached effectively.
4. The brain controls everything. So if the brain suffers, the effect can involve practically any function. However, I would insist you not to unnecessarily worry.
5. Apart from neurodevelopmental evaluation and follow up (including developmental therapy and physical therapy) there is hardly anything more that needs to be done. Be sure to talk continuously with your baby.
Let me know if I could help further.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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