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Pediatrics/toe walking and delayed development, no autism


QUESTION: Rsp Sir, following is written in the mri report of my son (3.5yr) - Patchy T2 and FLAIR hyperintense lesions in bilateral peritrigonal and posterior parietal periventricular white matter represent non-myelinated white matter in the terminal zones of myelination. : these were the conclusion statement and rest findings are normal.
I m conculting neurophysician regarding my son's  problems as: He had bit delayed milestones since birth. though pregnancy and delivery was normal. my son has delayed speech and has balancing problems which is taken careoff by physiotherapy and speech therapy. his attention problems r there as well. rest he is good and friendly with people. according to doc he has sensory issues which we takecare during therapy.
Kindly advise what the MRI is saying here. and any further treatment u suggest.
Thanking you, with warm regards.

ANSWER: MRI report here suggests that there is some definite permanent damage to brain due to unknown reasons; this is primarily responsible for his speech and milestone affection.

its very important to understand exact what is delayed and what he is not able to do expected for his age, so that occupational therapists ( and not physiotherapist alone), will be able to understand and modify his sensory motor issues.

It may be likely that some issue of mental retardation or autism amy coexist; but needs detailed screening in that direction.
delayed consultations with occupational therapists and psychologists make the out come poor and delayed.

feel free to write back if any further issues.

---------- FOLLOW-UP ----------

QUESTION: thanks for your reply sir. what kind of detailed screening will reveal his problems?  we have done karyotyping test also. its normal. all kind of blood test also. Vit D supplement was given to him. his understanding is delayed as per other kids of his age and not IQ. he lacks stranger anxiety. his birth was normal and he cried immediately. nothing was shown in neonatal stage during my pregnancy also all test were normal.
our pediatrician told me that due to nonmmylenated neurons the understanding part is affected. his brain will not be able to process things faster as mylein sheath is not present.
should we show him to neurologist or we should go for occupational therapy.
thanks and with warm regards.

occupational therapist with sensory integration will be major help.. pediatrician can support too.
screening for Autism, screening for hearing-speech , screening for neurodeficit in form of tone/power which may need muscle relaxants at times.

some stimulant neuropsychaitric drugs may be needed depending on the situation.


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Dr Kondekar Santosh Venketraman Pediatrician MD, DNB, Mumbai India, Online Pediatrician


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