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How can a baby's asymmetrical head be treated?

Q: My 2 years old son was born premature at 7.5 months and He weighed 1.1 kg due to intrauterine growth restriction (IUGR). He has now been diagnosed with abnormal head contour representing plagiocephaly and it is confirmed through MRI of brain. Is it curable? Does my son have cerebral palsy (CP)? He does not sit or stand and has 80% control over his neck. We are doing physiotherapy. Please advise.

A:Plagiocephaly is a condition characterised by an asymmetrical distortion (flattening of one side) of the skull. It is a common finding at birth as a result of a restrictive intrauterine environment. The unusual head shape is caused by pressure in the womb. It is common in babies nursed in one position. Treatments for correction of head shape range from a simple repositioning of babies below the age of 5 months, use of a helmet for children under the age of 18 months, and or surgery. However, these decisions depend on the general status and neurological development of the child. Plagiocephaly by itself is unlikely to produce severe neurological deficits or developmental delay even though many newborns with cerebral palsy managed in nurseries develop plagiocephaly. Your baby had severe intrauterine growth retardation, and is still unable to sit or stand at 2 years. The abnormal shape of skull might have been due to poor growth of brain and/or constant positioning of the head in a position during nursing and sleep. Please consult a developmental paediatrician or paediatric neurologist for further advice and management. The details provided are insufficient to place a label of cerebral palsy (CP) even though it cannot be excluded.


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