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Condition/Disorder Synonyms

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  • Fetal alcohol syndrome

  • Partial fetal alcohol syndrome

  • Alcohol related neurological disorder

  • Alcohol related birth defects

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ICD-9-CM Code

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  • 779.4 Drug reactions and intoxications specific to newborn1

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ICD-10-CM Code

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  • Q86.0 Fetal alcohol syndrome (dysmorphic)2

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Preferred Practice Pattern

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Key Features

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Description

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  • Includes range of severity of defects related to excessive maternal consumption of alcohol during pregnancy4

  • Characterized by

    • Short stature

    • Microcephaly

    • Developmental delays

    • Atypical facial features

    • Cognitive impairment

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Essentials of Diagnosis

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  • Partial fetal alcohol syndrome

    • Characterized by at least two typical facial characteristics and one other typical syndrome characteristic4

  • Alcohol related neurological disorder (ARND)

    • Less severe form4 that does not involve atypical facial features but does involve at least one other typical syndrome characteristic4

  • Alcohol related birth defects

    • Includes at least two facial characteristics, at least one major congenital organ defect, and at least two minor defects2

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General Considerations

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  • Prenatal exposure to alcohol is the most common preventable cause of mental retardation

  • May also have4

    • Cardiac defects

    • Neural tube defects

    • Genitourinary defects

    • Behavioral problems

      • Stranger anxiety

      • Inappropriate social interactions

      • Poor judgment

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Demographics

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  • 30% to 40% of offspring of mothers whose daily intake of alcohol exceeds 3 ounces4

  • 0.5 to 2 per 1,000 live births4

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Clinical Findings

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Signs and Symptoms4

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  • Growth

    • Short stature

    • Developmental delay

    • Failure to thrive

    • Prenatal and postnatal growth deficiency

  • Craniofascial

    • Short palpebral fissures

    • Atypical facial features

    • Flat philtrum

    • Thin vermillion of upper lip

  • Central nervous system

    • Microcephaly

    • Optic nerve hypoplasia

    • Hypotonic

    • Partial or complete agenesis of the corpus callosum

    • Cognitive impairment

    • Tremors

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Functional Implications

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  • Difficulty with complex cognitive function4

  • Short attention span

  • Difficulty with short term memory

  • Difficulty with balance and coordination

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Possible Contributing Causes

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  • Consumption of more than 3 ounces of alcohol per day during pregnancy4

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Means of Confirmation or Diagnosis

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Imaging

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  • Computerized tomography (CT scan)

  • Magnetic resonance imaging (MRI)

  • Maternal ultrasound

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Treatment

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Medication

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  • There are no medications that directly address FASD

  • Medications may be used to treat symptoms such as:

    • Stimulants to treat hyperactivity

    • Antidepressants, antianxiety medication, or neuroleptics to address behavioral difficulties5

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Referrals/Admittance

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  • Neurologist

  • Otolaryngologist

  • Gastroenterologist

  • Occupational therapist

  • Speech therapist

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Impairments

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  • Frequently fall when walking

  • Decreased coordination

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Tests and Measures

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  • Bayley Scales of Infant Development-II

  • Peabody Development ...

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