Symptoms of idiocy

Not everyone has a healthy physique in life. Many people have some problems with their physique, or even developmental disorders, such as a type of patient called congenital idiocy. The main symptoms are peculiar skin texture, intellectual functional disorders, including developmental deformities of the chest, abdomen and bones. The patient may have these problems on the face and limbs.

What are the symptoms of congenital idiocy? Besides being able to identify it at a glance in the crowd, what other symptoms can be used to determine whether it is congenital idiocy? In fact, we can check whether the limbs are abnormal, where the skin texture is special, intellectual disability, degree of chest and abdominal deformity, bone development, head and face, and other aspects of height. It is easier to approach from these aspects.

1. Children with limb diseases have severe hypotonia, soft joints of the limbs, and can climb and flip at will. Their hands are wide and thick, with short fingers. The end of the little finger often bends inward, and its middle phalanx is shorter and wider than normal. The feet are broad and thick, with the big toe set far apart from the other four toes.

2. Skin texture: There is only one palm line, which is a through-hand or Sydney line. The distal position of the axial triradiate is t″, the atd angle is increased (>63°, normal <45°), there is only one crease on the little finger, the frequency of the fingerprint bucket-shaped pattern decreases, and the dustpan-shaped pattern increases. The number of dustpan patterns on the ring finger and little finger increases, the number of dustpan patterns on the ulnar side of the index finger increases, and the (big toe) ball has an arch pattern on the tibial side.

3. Intellectual disability The degree of intellectual disability ranges widely. Generally, the IQ is 50 at the age of 5, which gradually decreases to 38 at the age of 15. Lack of abstract thinking ability. The intelligence level of children with mosaicism is usually higher than that of children with trisomy 21, with an average IQ of 67. Some chimera children have better language development and fewer visual comprehension disorders, and some have near-normal intelligence.

4. The chest, abdomen, neck and back are short and wide. 50% may be accompanied by congenital heart disease, which are in the order of atrioventricular commissure, ventricular septal defect, atrial septal defect, patent ductus arteriosus, tetralogy of Fallot, etc. Due to low muscle tone, the abdomen is distended, often accompanied by rectus abdominis separation and umbilical hernia. The main digestive tract malformation is duodenal stenosis, and esophageal tracheal fistula, diaphragmatic hernia, pyloric stenosis, annular pancreas, anal atresia, megacolon, rectal prolapse, etc. can also be seen.

5. There are obvious bone abnormalities in the skeleton, such as a small pelvis, extended iliac wings, flat acetabulum, tapered ischium, and acetabular index (the sum of the acetabular angle and the hip bone angle) <68°. The middle and distal phalanges of the little finger are underdeveloped, and decalcification can be seen on X-rays. There are often irregular indentations at the distal end of the first metacarpal and the proximal end of the second metacarpal. Two ossification points were seen on the manubrium of the sternum, and the 12th pair of ribs was absent. The frontal sinus disappears, the frontal suture persists, and the bone age is slightly delayed.

6. The height and weight of the child are lower than normal, and the average height and weight at birth are lower than those of normal babies. Prone to respiratory infections, digestive disorders and blepharitis. Increased cardiovascular excitability, heart failure, and impaired temperature regulation (often hypothermia) are sometimes seen. Pneumoencephalography can sometimes reveal enlargement of the subarachnoid space and bilaterally symmetrical ventricular dilatation. 10% may suffer from epilepsy, and the rate of leukemia is about 20 times higher than that of normal children.

7. Special facial features can be seen on the head and face soon after birth. There may be a third fontanelle, a short head, a round and flat face, which is related to the poor development of the nasal bones and maxillary bones. The eyeballs are relatively protruding, the palpebral fissure is obviously slanted upward and outward, the two eyes are far apart, and there are epicanthus at the inner corners of the palpebral fissure (this feature is only useful for Caucasians, as many normal people in my country also have it, so it cannot be used for diagnosis). Nystagmus and a few have cataracts.

The eyelashes are sparse and short, and blepharitis and strabismus are common. White spots on the iris, especially when the iris is blue (Brushfield spots, which are small round white spots, slightly irregular, forming a ring at the junction of the outer 1/3 of the iris). The root of the nose is flat due to the underdevelopment of the nasal bridge, the nose is short, and the nostrils are upturned.

The mouth is small and half open, with a high palate arch, thick lips and a thick tongue that often protrudes out of the mouth. Glossitis and epidermal excoriation may be seen, and cracks may be seen in older children. Some children have cleft lip, cleft palate, excessive drooling, silly smile, and delayed tooth eruption. The overall impression is one of dullness. The ears are small and round, the upper edge of the helix is ​​excessive, the ear length is reduced, and the earlobes are small and adhered. The base of the helix develops abnormally and moves downward to the concha, making the external auditory canal small.