Q: My son (born at 37 weeks) didn't cry at birth. He had apgar scores of 1, 4, 5 at 0, 1, 5 minutes and had seizures immediately after birth. The seizures lasted for 3 days. He was on ventilator for 5 days. He also had Grade I Intracranial haemorrhage which resolved in 3-4 days. He recovered from the symptoms within 4-5 days and started sucking. His EEG at 2 weeks showed no abnormalities. His neurological exam at discharge was normal other than a somewhat suppressed Moro's relex, which normalised later. He also had strabismus and cried rarely. He is 2 months old now. The strabismus has disappeared and crying is normal. His hands, legs and neck are stiff and resistant to movement sometimes. The resistance is not velocity dependent. He moves around very well except for the stiffness and posturing. His voluntary movements seem normal for his age. He started smiling at 6-7 weeks and is responsive. He can hear and see quite well. He has trouble sleeping and cries excessively, which is getting better. What are his risks of developing cerebral palsy? How severe could it be? What are the risks associated with mental retardation? Is there a chance he may outgrow his present symptoms?

A:Your child needs a careful follow-up since some babies with his kind of history may be found to have problems later. These could range from cerebral palsy or more subtle involvement involving behaviour, intelligence etc. It is not possible to give an exact estimate of chances that your child has for developing them, since these may manifest at varying ages. Certainly if you feel his legs & neck are stiff he should be evaluated by a paediatrician and also by an occupational therapist who can advise early remedial measures. Whatever damage the brain has incurred cannot be reversed and will also not be progressive, but early stimulation under the guidance of an occupational therapist shall help improve the outcome