A smaller than normal head size is the classical symptom of microcephaly. Many children often have a normal head size at birth; but eventually as the child grows, the size of the head appears to become proportionately smaller compared to the rest of the body.

Some percentages of affected children also are dwarf and underweight. In addition, development of other motor functions is delayed and neurological defects are evident. Seizures and convulsions are a common accompaniment of microcephlay. Some children with microcephaly may develop clumsiness while some other may develop spastic qualdriplegia. Affected children develop a large head with a preceding forehead and a wrinkled scalp [6].

• Developmental Delay

  It presents with developmental delay, visual problems and macrocephaly. We report a ten-month old boy with Canavan disease who presented with global developmental delay, seizures, abnormal eye movements and microcephaly. [ncbi.nlm.nih.gov]

  Additionally, services such as speech or physical therapy to help with developmental delays can help children. [abcnews.go.com]

• Asymptomatic

  Because the infection is so frequently asymptomatic or easily mistaken for other viral infections, the number of pregnant women infected and the stage of pregnancy at which infections occur are unknown. [iflscience.com]

  In addition, the virus has been detected in one asymptomatic case in Beijing. [ecdc.europa.eu]

  Treatment For those who are developmentally normal and asymptomatic, no treatment is required. In other children, treatment is supportive and depends on the child's symptoms and development. [healthcentral.com]

  Testing of asymptomatic pregnant women is not recommended in the absence of fetal microcephaly or intracranial calcifications. Zika virus RT-PCR testing can be performed on amniotic fluid ( 7, 9 ). [doi.org]

• Failure to Thrive

  Failure to thrive and mild facial dysmorphic features were also present. To our knowledge, this complex malformation (neurocutaneous) phenotype has not been previously reported. [ncbi.nlm.nih.gov]

  ‘However, three or more minor malformations, especially if associated with short stature or failure to thrive, microcephaly or developmental delay, should engender further investigation.’ [en.oxforddictionaries.com]

  Among them may be present: failure to thrive, spasticity (involuntary muscle contractions), impaired motor function, mental and psychomotor retardation, seizures, sight loss and hearing problems, joint and skeleton deformities (including dwarfism – short [medigoo.com]

  Then, they reversed course, saying that the severity of her microcephaly was stronger than they had initially imagined, and she was showing a failure to thrive. They told Gwen she should get ready to say goodbye to her precious girl. [redbookmag.com]

  After birth, a baby with microcephaly may have these signs and symptoms: Small head size Failure to thrive (slow weight gain and growth) High-pitched crying Little appetite or problems with feeding Muscle spasms To diagnose microcephaly after birth, your [marchofdimes.org]

• Jaundice

  It can cause jaundice, rashes, and seizures in infants. If you’re pregnant, you should take precautions by washing your hands frequently and not sharing utensils with children under age 6. [healthline.com]

• Blister

  The patient also exhibited spattered blisters and reduced hair density on her head, anisochromasia with reticular hyperpigmentation and hypopigmentation on the trunk, which she has had since the age of 4 and had been found by her parents. [ncbi.nlm.nih.gov]

• Hearing Impairment

  All three patients presented with transitory metabolic acidosis in the neonatal period and development of persistent renal de Toni-Debré-Fanconi-type tubulopathy, with subsequent rachitis, short stature, microcephaly, sensorineural hearing impairment, [ncbi.nlm.nih.gov]

• Clumsiness

  Motor ability varies, ranging from clumsiness in some to spastic quadriplegia in others. [zikavirusnet.com]

  Some children with microcephaly may develop clumsiness while some other may develop spastic qualdriplegia. Affected children develop a large head with a preceding forehead and a wrinkled scalp. [symptoma.com]

  Motor ability varies, ranging from clumsiness in some to spastic quadriplegia in others. Generally there is no specific treatment for microcephaly. Treatment is symptomatic and supportive. [web.archive.org]

  Motor ability varies, ranging from clumsiness in some to spastic quadriplegia in others.[9] Causes[edit] Neural scans of a normal-sized skull (left) and a case of microcephaly (right) Microcephaly is a type of cephalic disorder. [en.wikipedia.org]

• Neurologic Manifestation

  Although the disease is self-limiting, cases of neurologic manifestations and the Guillain–Barré syndrome were described in French Polynesia and in Brazil during ZIKV epidemics. 5,6 Recent reports from the Ministry of Health of Brazil suggest that cases [nejm.org]

At birth, if microcephaly is suspected, then a thorough checkup should be carried out. In addition, the head circumference should be measured and compared with standardized growth charts. In many cases, the head circumference of the parents can also be measured to determine whether the condition is a common occurrence in the family. Parents should be asked about the developmental milestones of the child to further understand the condition.

If there are signs of developmental delay, certain tests along with Computerized Tomography (CT) scan and Magnetic Resonance Imaging (MRI) of the head will be required to determine the underlying disease conditions [7].

In many cases, it is possible to detect microcephaly by prenatal ultrasound examination carried out during the third trimester. However, the condition can be difficult to diagnose in the early stages of fetal development [8].

• So far there is no treatment regime to enlarge the child’s head. If craniosynostosis is the underlying cause of microcephaly, then surgery can be done to correct the fusion and provide space for development of child’s brain. However, in other conditions, only supportive therapy is indicated to manage the symptoms and improve the child's quality of life.
• Medications are given in cases when the child is hyperactive or is experiencing seizures and convulsions. In addition, various types of therapies such as speech, occupational and physical are also employed in the early developmental years.
• If microcephaly is diagnosed at birth, then frequent examinations are required in order to monitor the brain development of the child. The child’s family is also given education about the disease which is helpful in improving the child's quality of life.

Microcephaly cannot be treated. The treatment regime that is administered is supportive in nature, primarily geared towards improving the quality of life of the affected children. The life expectancy of children with microcephaly is greatly reduced and the chances of having a normal brain function are poor.

Abnormal development of the brain during infancy or fetal growth can lead to a head size that is smaller than normal. In many cases, microcephaly occus as a result of genetic factors. Other factors which can also favor abnormal brain development include the following:

• Craniosynostosis, which causes premature fusion of sutures leading to abnormal brain growth
• Cerebral anoxia, that causes decreased oxygen supply to the brain during fetal growth
• Chromosomal abnormalities such as Down syndrome
• Infections during pregnancy and exposure of the fetus to drugs or alcohol and toxicogenic compounds
• Development of phenylketonuria and severe malnutrition during pregnancy [2]

The average prevalence of microcephaly is estimated to be 25%. The condition of microcephaly can also lead to intellect disability; however, in about 15% cases, the child has normal intellectual levels [3]. In a study carried out on children affected by microcephaly, it was found that 10.5% of them had IQ scores below 70; whereas, 28% of them had IQ scores 70 – 80. In the US, about 25,000 infants annually develop microcephaly [4].

The growth of the head depends on the brain development. When the brain cannot grow at a normal rate, microcephaly develops. Various genes and genetic defects have a pivotal role to play in the development of microcephaly. Studies have postulated the fact that mutation occurring in the DNA repair pathway is one of the major causes of poor brain growth. In addition to genetic mutations, centrosomal abnormalities are another factor that favor the development of microcephaly [5].

It is not always possible to prevent the development of microcephaly. However, parents with affected children may want to consider genetic counseling for future pregnancies [9].

In addition to this, pregnant mothers can take certain steps to avoid exposing the fetus to alcohol, drugs, toxins and other chemical compounds. Pregnant women are also advised to consume a nutritious diet to avoid malnutrition because severe malnutrition has been identified as a potential risk factor for poor brain development during fetal growth [10].

Children affected with microcephaly have to face serious developmental problems and deteriorated quality of life. So far, there is no treatment for correcting this condition; however, if supportive therapies are introduced in the early stages; the quality of life of the affected children can be improved. Interplay of various genetic and environmental factors is known to play a role in the causation of microcephaly [1].

Microcephaly is a condition in which the head of a child is smaller than normal for his age. It is frequently accompanied by  underlying disorders of the brain and mental retardation. It usually results from genetic abnormalities. Exposure of the fetus to toxins, alcohol and chemicals during pregnancy also causes poor brain growth and contributes to the development of microcephaly. Symptoms of microcephaly include seizures, convulsions, high pitched crying, mental retardation and developmental delays. The diagnosis of microcephaly is made by measuring the head circumference of the affected child. Thereafter, several tests to determine the growth of the child are done at various stages of growing years. There is no specific treatment for microcephaly. Medications are given for managing the symptoms of seizures, convulsions and hyperactivity. Speech and occupational therapy are also indicated to improve the quality of life.

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