Brain Disorders and Mental Subnormality

There is great variation in the degrees of incapacity, both mental and physical, of infants born with inadequate brains, inborn errors of metabolism, or inherited degenerations, as well as those whose brains are permanently affected by birth injury or by early illness such as meningitis. Each case needs assessing separately as the incapacity can be alleviated in some cases and little can be done for others from the medical point of view.

Down’s Syndrome (Mongolism)

About one in four of idiots suffer from this inborn genetic fault - an extra chromosome in their cells. With patience the higher grade mongol babies can be trained to walk, feed themselves and sometimes to be independent in toilet habits although at a much slower pace than a normal child. No known drugs are of use for this condition.

Cerebral Palsy

These children suffer from varying degrees of spasticity (muscle tense-ness and rigidity) owing to damage in the muscle-controlling brain cortex and the basal ganglia, probably at birth. Some suffer only from a mild difficulty in walking whereas others can scarcely walk at all and find speech difficult.

The brain lesions are irreversible but in many cases the intellectual functions are not damaged, so these children may go to a special school for education and training.

Inborn Errors of Metabolism

If the disorder in the baby is recognised early and the appropriate drugs regularly given, the child is likely to grow up into a fairly normal adult, though he will always need to take the vital drug. This is particularly so in cretins if given thyroid treatment right from babyhood.

All babies are now tested routinely for phenylketonuria by a heel stab test shortly after birth. A permanent diet low in phenylalanine can allow such a child to develop normally, both physically and mentally.

Headache

Headache in childhood is extremely common, although it may be difficult to recognise. It may occur in many disorders, the most common cause being some intestinal disturbance such as constipation or indigestion.

It is often present with fever, and a child with acute tonsillitis or acute infection of the ear may make no other complaint than that of headache. It is usually an early symptom of infectious disease such as measles, pneumonia, or scarlet fever.

Nervous children of the restless, rapidly exhausted type are very subject to headache, and it is particularly common in rheumatic children. It is also a symptom of bilious attacks from acidosis and of attacks of cyclical vomiting. Another form of nervous headache in children is due to migraine, when it may be also associated with fever and vomiting.

Head Rolling

This habit is sometimes met with in infancy. It is characterised by forcible rubbing of the back of the head from side to side against the pillow, so that the hair at the back of the scalp is completely rubbed off. One explanation is that the head sweats, so that contact with a hot and moist pillow gives rise to itching which is relieved by friction.

It is sometimes caused by inflammation in the ear.

Treatment

A bran pillow with a slight depression in the centre should be provided. Inflammation of the ear, or rickets, if present, should be appropriately dealt with.

Head Banging

It is difficult to assign a cause to this curious condition. It may result from pain in the head or ears, but in most cases no explanation can be found, and it is remarkable with what force a child will continue to bang his head against the sides of his cot without apparently experiencing any pain. Such habits are practically harmless unless they are allowed to become fixed, in which case they may aggravate an existing nervous condition. It is important to make sure that the general management of the child is satisfactory.

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