Using my new Firefox search box to search ScienceBlogs, I
learned that Fetal
Alcohol Syndrome (FAS) retards
neural growth, screws
up the circadian clock, is the subject
of moralistic cartoons, and that it cannot
True enough, it cannot be cured. Even so, it is
important to recognize it, as early as possible, so that the
problems can be managed more effectively.
In the most obvious cases, the diagnosis is not difficult.
Many are not so obvious, however. The diagnosis
generally is established by inspection of facial features.
Typical characteristics include:
# Small head
# Small upper jaw
# Short, upturned nose
# Smooth groove (philtrum) in upper lip
# Smooth and thin upper lip
# Narrow, small eyes with large epicanthal folds
A drawing that illustrates the facial abnormalities can be seen at the NIAAA
Other characteristics include low IQ, poor coordination, ventricular
septal defect (VSD) or atrial septal defect (ASD), and abnormal joints,
hands, feet, fingers, and toes. Behavioral problems are
common. FAS is one of the more common causes of mental
retardation, but the incidence varies considerably depending on the
population studied and the methodology used. In the USA, the
reported incidence increases
almost every year, but this could be due to improved
detection. The incidence is probably about 4 per 1,000 live
births, but that is a soft number. I see lower and higher
figures in various places.
The societal consequences are significant. The cost to US society is
estimated at over
$300 million per year.
So, we would really like to have a good, reliable way to establish the
diagnosis. Unfortunately, there is no chemical or genetic
test. The diagnosis requires the eye of an experienced
clinician. Now, IEEE Spectrum reports on
the development of a laser scanner-camera device that can create a 3D
image of the face, feed the image into a computer, and provide a good
indication of the probability of the diagnosis of FAS.
Medical Imaging Could Improve Doctors’ Ability to Diagnose Fetal
By Josh Romero
First Published November 2007
16 November 2007—Digital facial models created
from three-dimensional scans could give doctors a new diagnostic tool
for identifying children with fetal alcohol spectrum disorders, a broad
range of effects resulting from alcohol exposure in the womb. Although
such children often have symptoms common to other developmental
disorders, they require different interventions, and better diagnostics
could help more kids get the right treatment…
…To make a diagnosis, experts called dysmorphologists rely on
identifying specific facial features, growth deficits, and cognitive
difficulties. Just as behavioral indicators are not unique to fetal
alcohol syndrome, dysmorphologists can’t use any single
feature to reliably assess a child’s face. Instead, they look
for a signature combination of features that include small eye
openings, a thin upper lip, and a smooth area between the lips and nose
that, together, indicate an abnormality.
Unfortunately, this approach doesn’t work for all patients…
The image comes from Konica Minolta.
The scanner captures depth data accurate
to less than a millimeter by scanning a low-intensity, “eye
safe” laser line over the face while simultaneously capturing
a low-resolution color picture. A camera in the scanner measures the
time it takes the laser pulses to reflect back from the face. By
combining this information with the known distance between the laser
source and the camera, the software can calculate the 3-D coordinates
for each point on the face and then overlay the color data.
The initial study correctly detected about 75% of the cases.
Presumably, with more data, and with refinements to the
computerized anthropometry technique, that number can be improved.
The technique is being validated by a medical
anthropologist, Elizabeth Moore, PhD, and others.
Their work was published
in the October issue of Alcoholism: Clinical and Experimental
Research [31 (10), 1707–1713.