FETAL ALCOHOL SYNDROME : Hearing, Speech, Language, and Vestibular Disorders - 08/09/11

Doi : 10.1016/S0889-8545(05)70359-4

Michael W. Church, PhD ^a,^b, Ernest L. Abel, PhD ^a,^c
^a Departments of Obstetrics and Gynecology (MWC, ELA)
^b Otolaryngology (MWC), Audiology and Communication Disorders (MWC)
^c Psychology (ELA), Wayne State University School of Medicine, Detroit, Michigan

Resumen

Maternal alcohol abuse during pregnancy is associated with several alcohol-related birth effects.^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Haga clic aquí para ir a la sección de Referencias} A pattern of these birth effects consisting of prenatal or postnatal growth retardation or both, craniofacial anomalies, and nervous system defects^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Haga clic aquí para ir a la sección de Referencias, 26Jones K.L., Smith D.W. Recognition of the fetal alcohol syndrome in early infancy Lancet 1973 ; 1 : 999-1001 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 46Rosett H. A clinical perspective of the fetal alcohol syndrome Alcohol Clin Exp Res 1980 ; 4 : 119-122 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} is called fetal alcohol syndrome (FAS)^{26Jones K.L., Smith D.W. Recognition of the fetal alcohol syndrome in early infancy Lancet 1973 ; 1 : 999-1001 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} or, more recently, fetal alcohol abuse syndrome.^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Haga clic aquí para ir a la sección de Referencias} The incidence of FAS in the United States is about 2 cases per 1000 population; the incidence among children born to heavy drinkers is about 4%.^{1Abel E.L. An update on incidence of FAS: FAS is not an equal opportunity birth defect Neurotoxicol Teratol 1995 ; 17 : 437-443 [cross-ref]

Haga clic aquí para ir a la sección de Referencias}

Mental retardation and other neurodevelopmental disorders such as hyperactivity, distractibility, short attention span,^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Haga clic aquí para ir a la sección de Referencias} poor judgment, impulsivity, poor social skills,^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Haga clic aquí para ir a la sección de Referencias, 40Olson H.C., Feldman J., Streissguth A.P. Neuropsychological deficits and life adjustment in adolescents and adults with fetal alcohol syndrome Alcohol Clin Exp Res 1992 ; 16 : 380

Haga clic aquí para ir a la sección de Referencias} poor visual and auditory memory,^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Haga clic aquí para ir a la sección de Referencias} and sensory problems involving ocular,^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Haga clic aquí para ir a la sección de Referencias, 54Stromland K. Ocular abnormalities in the fetal alcohol syndrome Acta Ophthalmol 1985 ; 63 (suppl 171) : 1-50

Haga clic aquí para ir a la sección de Referencias, 55Stromland K., Pinazo-Duran M.D. Optic nerve hypoplasia: Comparative effects in children and rats exposed to alcohol during pregnancy Teratology 1994 ; 50 : 100-111 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} auditory,^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Haga clic aquí para ir a la sección de Referencias, 9Church M.W., Abel E.L., Kaltenbach J.A., y al. Effects of prenatal alcohol exposure and aging on hearing function in the rat: Preliminary observations Alcohol Clin Exp Res 1996 ; 20 : 172-179 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 10Church M.L., Eldis F. Correlations between craniofacial, hearing, and language disorders in the Fetal Alcohol Syndrome Alcohol Clin Exp Res 1997 ; 55 : 57

Haga clic aquí para ir a la sección de Referencias, 11Church M.W., Eldis F., Blakley B.W., y al. Hearing, speech, language, vestibular and dentofacial disorders in the Fetal Alcohol Syndrome (FAS) Alcohol Clin Exp Res 1997 ; 21 : 227-237 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 12Church M.W., Gerkin K.P. Hearing disorders in children with Fetal Alcohol Syndrome: Findings from case reports Pediatrics 1988 ; 82 : 147-154

Haga clic aquí para ir a la sección de Referencias, 13Church M.W., Holloway J.A. The effects of prenatal alcohol exposure on postnatal development of the brainstem auditory evoked potential in the rat Alcohol Clin Exp Res 1984 ; 8 : 258-263

Haga clic aquí para ir a la sección de Referencias, 40Olson H.C., Feldman J., Streissguth A.P. Neuropsychological deficits and life adjustment in adolescents and adults with fetal alcohol syndrome Alcohol Clin Exp Res 1992 ; 16 : 380

Haga clic aquí para ir a la sección de Referencias} and possibly vestibular problems^{11Church M.W., Eldis F., Blakley B.W., y al. Hearing, speech, language, vestibular and dentofacial disorders in the Fetal Alcohol Syndrome (FAS) Alcohol Clin Exp Res 1997 ; 21 : 227-237 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 14Clarren S.K. Recognition of fetal alcohol syndrome JAMA 1981 ; 245 : 2436-2439

Haga clic aquí para ir a la sección de Referencias, 29Kyllerman M., Aronson M., Sabel K.-G., y al. Children of alcoholic mothers: Growth and motor performance compared to matched controls Acta Paediatr Scand 1985 ; 74 : 20-26 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 37Nordemar H. Alcohol and ultrastructural changes in the developing inner ear Acta Otolaryngol 1988 ; 105 : 75-81 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} are among the most devastating results of maternal alcohol abuse during pregnancy. Because normal postnatal development of higher central nervous system (CNS) structures is critically dependent on normal sensory function, impairment of sensory function can be conceived of as a form of sensory deprivation.

Studies of the developing visual and auditory systems clearly indicate that sensory deprivation during a critical period of postnatal maturation can compromise normal maturation of neural synapses, dendritic arborization and spinal development, myelination, neuronal cell size, cell number, and the organization of visual^{43Riesen A.H. Effects of stimulus deprivation on the development and atrophy of the visual sensory system Am J Orthopsychiatry 1960 ; 30 : 23-36

Haga clic aquí para ir a la sección de Referencias, 58Wiesel T.N. Postnatal development of the visual cortex and the influence of environment Nature 1982 ; 299 : 583-592 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} and auditory structures^{57Webster D.B., Webster M. Neonatal sound deprivation affects brainstem auditory nuclei Arch Otolaryngol 1977 ; 103 : 392-396

Haga clic aquí para ir a la sección de Referencias} in laboratory animals and humans.

During postnatal development, critical periods exist during which stimulation is processed optimally. Once this period has passed, stimulation has a progressively diminished influence on development. In humans, this critical period for hearing and language development occurs during the first 2 or 3 years of life.^{38Northern J.L., Downs M. Hearing in Children Baltimore: Williams & Wilkins (1984).

Haga clic aquí para ir a la sección de Referencias} A hearing impairment during this period, even in an otherwise normal child, is tantamount to sensory deprivation and can result in permanent speech, language, and cognitive deficits; distractibility; hyperactivity; and impaired academic performance similar to that exhibited by individuals with FAS.^{2Abel E.L. Fetal Alcohol Abuse Syndrome Revisited New York: Plenum Press (1997).

Haga clic aquí para ir a la sección de Referencias, 26Jones K.L., Smith D.W. Recognition of the fetal alcohol syndrome in early infancy Lancet 1973 ; 1 : 999-1001 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 38Northern J.L., Downs M. Hearing in Children Baltimore: Williams & Wilkins (1984).

Haga clic aquí para ir a la sección de Referencias, 46Rosett H. A clinical perspective of the fetal alcohol syndrome Alcohol Clin Exp Res 1980 ; 4 : 119-122 [cross-ref]

Haga clic aquí para ir a la sección de Referencias}

This review focuses on the developmental effects of alcohol on the auditory system. The vestibular system is also examined, because it shares several embryologic, anatomic, and functional similarities with the auditory system, and because the inner ear and eighth cranial nerve contain the peripheral pathways of both these senses. Speech and language deficits are surveyed because they are both highly dependent on auditory function.

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Esquema

HEARING DISORDERS

Delayed Auditory Maturation

Sensorineural Hearing Loss

Conductive Hearing Loss and Recurrent Serous Otitis Media

Central Hearing Disorders

VESTIBULAR DISORDERS

SPEECH AND LANGUAGE DISORDERS

Language Disorders

Speech Disorders

RELATIONSHIPS BETWEEN CRANIOFACIAL AND COMMUNICATION DISORDERS

CONCLUSION AND COMMENTS

Address reprint requests to Michael W. Church, PhD, Fetal Alcohol Research Center, 275 East Hancock Avenue, Detroit, MI 48201
This work was supported by grants P5O AA 07606 from the National Institute on Alcohol Abuse and Alcoholism and RO1 DA 05536 from the National Institute on Drug Abuse and various research grants from Wayne State University.