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Nervous endemic cretinism in Eastern Nepal

N J White

    Developmental Medicine and Child Neurology
    |April 1, 1977
    PubMed
    Summary

    Nervous endemic cretinism in Nepalese children presents with psychomotor retardation, deafness, and spastic diplegia, unrelated to hypothyroidism. Gestational iodine deficiency is the likely cause, suggesting iodized oil injections for prophylaxis.

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    Area of Science:

    • Endocrinology
    • Neurology
    • Public Health

    Background:

    • Cretinism, a neurological disorder, is prevalent in mountainous regions.
    • Previous studies have described various forms of endemic cretinism globally.
    • The clinical manifestations in Eastern Nepal required detailed characterization.

    Purpose of the Study:

    • To delineate the clinical pattern of cretinism in children and adolescents from Eastern Nepal.
    • To investigate the potential causes of the observed cretinism.
    • To propose effective prophylactic measures.

    Main Methods:

    • Clinical examination of 31 children and adolescents.
    • Assessment of neurological and developmental parameters.
    • Correlation of clinical findings with geographical and environmental factors.

    Main Results:

    • The study identified a pattern consistent with nervous endemic cretinism.
    • Key features included psychomotor retardation, deafness, and spastic diplegia.
    • No clinical signs of hypothyroidism were observed in the affected individuals.

    Conclusions:

    • The observed cretinism is strongly linked to gestational iodine deficiency.
    • Iodinated poppyseed oil (Lipiodol) injections are proposed as a suitable prophylactic treatment.
    • Public health interventions targeting iodine supplementation are recommended for this region.

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