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  • Fetal alcohol syndrome
  • Partial fetal alcohol syndrome
  • Alcohol related neurological disorder
  • Alcohol related birth defects

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  • 779.4 Drug reactions and intoxications specific to newborn1

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  • Q86.0 Fetal alcohol syndrome (dysmorphic)2

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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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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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Imaging

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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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  • Neurologist
  • Otolaryngologist
  • Gastroenterologist
  • Occupational therapist
  • Speech therapist

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  • Frequently fall when walking
  • Decreased coordination

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  • Early intervention services5
  • Behavioral therapy5
  • Developmental activities
    • Acquisition of motor milestones through facilitation
  • Therapeutic exercise
    • Coordination
    • Balance
    • Strengthening

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  • Ambulate through an obstacle course without falling within 3 months to increase stability
  • Walk forward on a low balance beam independently without falling within 4 months to increase balance ...

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