Microcephaly

Microcephaly

Microcephaly is a condition where a baby’s head is smaller than expected for their age and sex. This is usually related to differences in how the brain develops during pregnancy or how the brain grows after birth.

Microcephaly can occur on its own or alongside other conditions. It can affect children in very different ways. Some children may have few associated difficulties, while others may experience developmental delay or difficulties with movement, communication, learning, feeding or other aspects of development.

Microcephaly itself is not usually a progressive condition. However, a child’s development and the difficulties they experience can change over time depending on the underlying cause and any associated conditions.

What causes microcephaly?

There are many possible causes of microcephaly. In some children, the exact cause may not be identified.

Possible causes include:

• Genetic changes: Changes in genes or chromosomes can affect brain development.

• Prenatal infections: Certain infections during pregnancy can affect the developing brain.

• Reduced oxygen or blood supply: Problems affecting the brain's blood supply or oxygen levels before, during or shortly after birth may affect brain development.

• Prematurity: Babies born prematurely may have an increased risk of microcephaly and associated developmental difficulties.

• Maternal health and nutrition: Severe malnutrition or certain health conditions during pregnancy may affect fetal brain development.

• Other medical conditions: Microcephaly can occur as part of a wider genetic or neurological condition.

How common is microcephaly?

Microcephaly is considered a rare condition. How frequently it occurs can vary depending on how microcephaly is defined, the population studied and whether mild or severe cases are included.

Rather than relying on a single prevalence figure, it is important to consider each child's individual diagnosis, development and any underlying condition.

What are the symptoms of microcephaly?

Microcephaly affects children differently. The difficulties a child experiences may depend on the underlying cause and whether there are other conditions affecting their development.

Possible difficulties include:

• Developmental delay, such as taking longer to sit, crawl, stand or walk

• Changes in muscle tone, including increased or decreased tone

• Reduced muscle strength or motor control

• Balance and coordination difficulties

• Stiffness or tightness in muscles and joints

• Difficulties with communication or learning

• Seizures

• Feeding or swallowing difficulties

• Vision or hearing difficulties

• Difficulties with posture and movement

Not every child with microcephaly will experience all of these difficulties.

How is microcephaly diagnosed?

Microcephaly may be identified during pregnancy or after birth.

Diagnosis usually involves measuring a baby's head circumference and comparing this with expected measurements for their age and sex. Healthcare professionals will also consider the child's medical history, growth and development.

Depending on the individual child, assessment may include:

• Monitoring head growth over time

• Developmental assessments

• Neurological and physical examinations

• Brain imaging, such as an MRI

• Genetic testing where an underlying genetic cause is suspected

• Assessment of associated difficulties, such as movement, vision, hearing, feeding or communication

A multidisciplinary team may be involved depending on the child's needs.

How is microcephaly managed?

There is no treatment that increases the size of the brain or reverses microcephaly. Management therefore focuses on supporting the child's development, function, participation and quality of life.

The support a child receives will depend on their individual needs and may involve several healthcare professionals, such as:

• Physiotherapists

• Occupational therapists

• Speech and language therapists

• Paediatricians

• Neurologists

• Dietitians

• Other specialist healthcare professionals

The aim is to support the child to develop and maintain skills, participate in everyday activities and achieve their individual potential.

How can physiotherapy help children with microcephaly?

Physiotherapy can support children with microcephaly who experience difficulties with movement, strength, balance, coordination, muscle tone or physical development.

Treatment is individually tailored to the child's abilities, needs and goals. Depending on their stage of development, physiotherapy may include:

Motor development

Supporting developmental skills such as head control, rolling, sitting, crawling, kneeling, standing and walking through activities that are meaningful and appropriate for the child.

Postural control

Activities to develop head, trunk and postural control, helping children maintain stable positions when sitting, standing and moving.

Strength and motor control

Play-based activities can be used to develop the strength and control needed for movement, transfers and everyday activities.

Muscle tone and flexibility

Where appropriate, physiotherapy may include positioning, active movement and stretching to help manage changes in muscle tone, maintain joint movement and support comfortable movement.

Balance and coordination

Reaching, stepping, standing and other movement activities can help develop balance, coordination, body awareness and confidence.

Walking and gait

For children who are learning to walk or developing their walking pattern, physiotherapy may include supported walking practice, gait activities and appropriate walking aids where needed.

Functional skills

Practising everyday movements such as moving between positions, getting up from the floor, standing and transferring can help children become more independent.

Supporting parents and carers

Physiotherapists can provide advice and practical strategies that can be incorporated into everyday routines, including positioning, safe transfers, movement activities and ways to encourage development through play.

Specialist equipment at Positive Steps

At Positive Steps, specialist rehabilitation equipment may be incorporated into a child's physiotherapy programme where it is appropriate for their abilities, needs and goals.

This may include:

EzyGain Treadmill
The EzyGain treadmill can provide supported walking practice and opportunities to work on gait and walking skills in a controlled environment.

Hydrotherapy
Water-based physiotherapy can provide an environment where children can practise movement, balance, strength and mobility with reduced weight-bearing. The warmth and buoyancy of the water may also make movement more comfortable for some children experiencing stiffness.

BlazePods
BlazePods can be incorporated into interactive, play-based activities to encourage reaching, stepping, reactions, coordination, balance and movement.

Equipment is selected as part of an overall physiotherapy programme rather than being suitable or necessary for every child.

Can physiotherapy help my child with microcephaly?

Yes. Physiotherapy cannot treat the underlying cause of microcephaly, but it can help address difficulties with movement, strength, balance, coordination, muscle tone, walking and functional skills.

For children who are still developing their movement skills, physiotherapy can help them practise and build on these skills through play and meaningful activities. For children who already have established movement patterns, physiotherapy can focus on maintaining function, developing new skills, supporting participation and helping them remain as independent as possible.

At Positive Steps, we work closely with children and their families to understand what matters to them and create goals around the things they want to achieve.

How can Positive Steps help?

Every child with microcephaly is different. Their physiotherapy programme should reflect their individual abilities, needs, development and goals.

At Positive Steps, we work with children and their families to identify meaningful goals and develop an individualised physiotherapy programme. This may focus on developing or maintaining movement skills, improving physical function and supporting participation and independence in everyday life.

Our approach is always focused on what can be done and finding ways to help each child thrive.

If you would like to find out more about how physiotherapy could support your child, please get in touch with the Positive Steps team.

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Find out more about microcephaly

For further information about microcephaly, including causes, diagnosis and support, we recommend speaking with your child's healthcare team and using reputable condition-specific information.

The Brain Charity also provides information about microcephaly and neurological conditions.