The first report of fetal alcohol effect in a 12 year-old child in Korea

Abstract

We present the first report of fetal alcohol effect in a 12 year-old child in Korea. The mother had consumed 162 g of alcohol per week continuously during pregnancy. His first febrile seizure occurred before he was 1 year old, and became more frequent 2 years later. He started showing signs of right paraplegia when he was 3.5 years old and brain MRI revealed periventricular leucomalacia near the left ventricle. He was microcephalic and his growth was retarded. He was irritable, impatient, impulsive, and inattentive, and showed disinterest in school activities and aggressive and dangerous behavior. After the diagnosis of attention deficit/hyperactivity disorder was made, psychopharmacological treatment and family support was initiated. After 10 months, he still had intermittent ideas of reference, although the aggressive behavior, inattentiveness, and impulsivity had improved. Using this case study, we stress the importance of maternal alcohol history in patients with these characteristics.

Keywords: Attention deficit/hyperactivity disorder; Fetal alcohol effect; Fetal alcohol spectrum disorder; Growth retardation; Pregnancy; Seizure.

FIGURE 1

FLAIR and T2-weighted brain MR image. A and B show a high signal intensity lesion on FLAIR and T2-weighted brain MR image, highly suggestive of periventricular leukomalacia, in the left corona radiata and centrum semiovale (Taken when the patient was 10 years old). FLAIR: fluid attenuated inversion recovery.

FIGURE 2

Electroencephalogram (ECG). The main feature of this recording is intermittent low amplitude spike discharges on both occipital areas (O1, O2). This record is suggestive of idiopathic partial epilepsy.

FIGURE 3

Bender-Gestalt Test (BGT). A: Copy. B: Recall. There is Curvature difficulty, Change in Angulation, distortion, slope and small size error. These findings suggest the developmental delay of visuomotor coordination and visuospatial function, the organic dysfunction of the brain, impaired planning, impulsivity and tendency of acting out.