TO DETERMINE ETIOLOGY OF GLOBAL DEVELOPMENTAL DELAY IN YOUNG CHILDREN

ABSTRACT
Background: Developmental delay are group of disorders of early onset estimated to affect 5% to 10% of childhood
population. It is commonest neurological condition after ADHD and epilepsy. It describes a clinical presentation that
has heterogeneous etiologies and is associated with age specific deficit in learning skills Accurate etiological determination,
despite the fact that many disorders have no specific therapeutic intervention, has specific implementation
regarding treatment, prognosis, ongoing medical management of associated conditions, assessment of recurrence
risk, counseling of families and implementation of preventive measures. The objective of this study is to determine the
common etiologies of global developmental delay so that we can modify our management accordingly.
Methods: This study was conducted from January 2014 to March 2015 in Kuwait teaching hospital Peshawar. Patients
6months to 5 years were enrolled having developmental delay in one or more domain in out patients department.
Neurodevelopmental delay was assessed on Denver scal. A detail history and examination carried out. Investigation
including CT brain, karyotyping, thyroid function tests, electromyogram, and nerve conduction studies were performed.
Results: A total of 170 patients were enrolled in study with developmental delay. Mean age was 32 months (range was
6 months to 5 years). History based evidence shows 90% having developmental delay and 10 % having regression.
101 patients (59.4%) had global developmental delay and 69 children (40.5%) had isolated developmental delay either
moter or speech delay. Patient having isolated moter delay where 41 (24.1%) while those having isolated speech delay
were 24 (14%). Etiology was identified in 70% of the children, while no specific etiology was identified in 30% of the
children. Hypoxic ischemic encephalopathy was the cause of developmental delay in 40 (23.5%) of the children. Brain
dysgenesis was present in 17(10%) of the patients. Kernicterus was present in 10 (5.8%) patients. Viral encephalitis
and meningitis were present in 7 (4.1%) and 10 (5.8%) respectively. Head trauma was present in 11(6.4%) children.
Among the genetic disorder Down syndrome was the commonest cause found in 4(2.3%) children. Neurodegenrative
disorder were present in 7(4.1%).3 (1.8%) children were having TORCH infection. 3 (1.8%) children were having spinal
muscular atrophy. Famileal moter delay was present among 7 (4.1%) children.
Conclusion: Developmental delay need to recognize in children by doing routine check-ups and follow ups at least
up to five years. Findings of specific etiologies early would have better out come in management and recurrence risk