Fetal alcohol spectrum disorder: Encyclopedia II - Fetal alcohol spectrum disorder - Brain damage and facial defects

Fetal alcohol spectrum disorder - Brain damage and facial defects

Craniofacial abnormalities are visible in children with FAS, though not in children with FAE. Generally, children with FAS have a smaller head circumference and low birth weight, and they may fail to thrive. Their facial features are distinctive and diagnostically significant, in that they are a sign of brain damage, although there may be brain damage without the visible facial effects.

Common findings are mild to moderate microcephaly; small palpebral fissure lengths (palpebral fissures are the opening of the eyelids, measured from between the exocanthion and endocanthion of each eye); a thin upper lip; smooth philtrum (the vertical "divot" or groove between the nose and upper lip); flattened cheekbones; and a short nose. [6]

Dr. Sterling Clarren, one of the world's leading FASD researchers, of the University of Washington's Fetal Alcohol and Drug Unit, told a conference in 2002.

I have never seen anybody with this whole face who doesn't have some brain damage. In fact in studies, as the face is more FAS-like, the brain is more likely to be abnormal. The only face that you would want to counsel people or predict the future about is the full FAS face. But the risk of brain damage increases as the eyes get smaller, as the philtrum gets flatter, and the lip gets thinner. The risk goes up but not the diagnosis.

At one-month gestation, the top end of your body is a brain, and at the very front end of that early brain, there is tissue that has been brain tissue. It stops being brain and gets ready to be your face ... Your eyeball is also brain tissue. It's an extension of the second part of the brain. It started as brain and "popped out." So if you are going to look at parts of the brain from alcohol damage, or any kind of damage during pregnancy, eye malformations and midline facial malformations are going to be very actively related to the brain across syndromes ... and they certainly are with FAS. [7]

As of 2002, there were 25 reports of autopsies on babies known to have been suffering from FASD. The first was in 1973 on a baby who died shortly after birth (Smith and Jones 1973). The examination revealed extensive brain damage, including microcephaly, migration anomalies, callosal dysgenesis, and a massive neuroglial, leptomeningeal heterotopia covering the left hemisphere (Mattson and Riley in Streissguth and Kantor, 2002, p. 10).

Sterling Clarren described a second baby born in 1977, whose mother was a binge drinker. The baby died ten days after birth. The autopsy showed severe hydrocephalus, abnormal neuronal migration, and a small corpus callosum (which connects the two hemispheres) and cerebellum (ibid).

Since then, FASD has also been linked to brainstem and cerebellar changes, agenesis of the corpus callosum and anterior commissure, migration errors, absent olfactory bulbs, meningomyelocele, and porencephaly (ibid, p. 11).

Adapted from the Wikipedia article "Brain damage and facial defects", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki