Mental Retardation neuro presentation.pdf

early detect mental

1. Early Detection and
Intervention of Mental
Sub Normality
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib
Prof. Dr. Bayoumi Gharib

2. Mental Retardation is defined as
significantly sub average general
intellectual functioning existing
concurrently with deficits in adaptive
behavior.
And manifested during the
developmental period ( before the
age of 18 years ).
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

3. Levels of severity of mental
retardation
•Mild mental retardation
•(50-55 to< 70)
•Moderate mental retardation
•(35-40 to >50-55 ).
•Severe mental retardation
•(20-25 to 35-40 ).
•Profound mental retardation
•(below 20 or 25 ).
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

4. Classification of the Recognized Causes of
Mental Handicap
Causes of mental handicap

•A Genetic
•Cerebral degenerative disorder
•Structural disorders
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib
Example
•Gangliosidoses
•Lipidoses
•Complex carbohydrates

•Mucopolysacchairdoses
•Leucodytrophies
•Tuberose sclerosis
•Familial hydrocephalus

5. Example
•Trisomy,
•e.g. down syndrome
•Deletion,
•e.g. cri du chat syndrome
•sex chromosome anomaly,
•e.g. fragile x syndrome
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib
Classification of the Recognized Causes
of Mental Handicap
Causes of Mental Handicap
A .genetic
*Chromosomal disorder

6. Causes of Mental Handicap
B- intrauterine
•Congenital infection
•
•Drugs
•Cerebral malformations







Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib
Classification of the Recognized Causes
of Mental Handicap
Example
•Cytomegalovirus
•Rubella
•Toxoplasmosis
•Phenytoin, alcohol
•Hydranencephaly , porencaphaly

7. *Metabolic Disorder
Amino Acid,
e.g. phenylketonuria.
Carbohydrate,
e.g. galactosaemia .
Organic Acid,
e.g. isovaleric acidaemia .
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

8. Causes of Mental Handicap
C- perinatal
•Problems during pregnancy :
•Problems during labour and
delivery :
•Neonatal problems :
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib
Classification of the Recognized Causes
of Mental Handicap
Examples

•pre-eclamptic toxaemia
antepartum hemorrhage
premature onset of labour .
•prolonged labour, fetal
distress , trauma and
asphyxia .
•Intraventricular hemorrhage
hypoglycemia, meningitis,
jaundice .

9. Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib
Classification of the Recognized Causes
of Mental Handicap
Causes of mental handicap Examples
D- postnatal
*Trauma Accidental or non-
Accidental injury.
* infection encephalitis,
meningitis
* anoxia Asphyxia, status epilepticus
* metabolic & endocrine hypoglycemia ,
hypernataraemia
* poisoning lead

36. Down syndrome is a syndrome
of multiple malformations with
characteristic appearance and
mental retardation
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

37. Associated Problems in Down Syndrome:
1 .Congenital heart malformation.
2 .Gastrointestinal tract.
3 .Genitourinary tract.
4 .Central nervous system.
5 .Hematological abnormalities.
6 .Immunity.
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

38. Parenatal Diagnosis of D.S
1 .Amniocentesis performed at 14-16 weeks of gestation.
2 .Chonionic villus sampling performed around 10 weeks
of gestation.
3 .Ultrasound scanning of the uterus & measuring the
biparietal diameter to femur length ratio.
4 .Serum alpha fetoprotein.
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

39. Eye defects:
Cataracts:
1 .Rubella
2 .Lowe's syndrome
3 .Galactoseamia
4 .Hypoparathyroidism
5 .Dystrophia myotonica
6 .mrinesco-sjogren syndrome
7 .Infants of pku mothers
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

40. Functional development of visual
system
•Vision ……… cortical function
•*Neonates
. fix and track 31-33 WGA
. Preferential looking 31 WGA
*Visual acuity:
. newborn 6/200
. 3 months 6/60
. 6 months 6/6
..…In correlation with maturation of visual pathways.
*Binocular vision : 2 months.
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

41. Mental retardation
presentation of mental retardation
PrenatalNeonatal 3-6 months
Maternal risk
amniocentesis
Ultrasound
Abnormal
Fetal activity
dysmorphisms/
Structural
Metabolic
Instability
Neurologic
Syndromes
1.coma/seizures
2.Tone
3.Feeding dysfunction.
Poor environmental
contact ( periodicity
visual and auditory
orienting )
Persistent colic
Dysmorphism
Feeding dysfunction tone
/ motor
Abnormality
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

42. *Later in the first year ,motor delays in
sitting and crawling may suggest developmental
delay.
*During the second and third years,
language and behavior abnormalities suggest
possible developmental retardation .
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

43. Diagnosis:
*history.
*Clinical examination.
*Investigations.
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

44. Early intervention & Educational
programs
Just as it important to identify and remediate
associated deficits , it is important to begin
an early educational and therapy program
to stimulate cognitive ,language and motor
development.
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

45. Genetic counseling
and supportive
psychotherapy also may be
appropriate
Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib

46. Early Detection and Intervention of Mental Sub Normality
Prof. Dr. Bayoumi Gharib