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13 month child having epicanthal folds, and slight low muscle tone in mouth. What are the complications?

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My daughter is 13 months old and was adopted at birth. She has epicanthal folds, and slight low muscle tone in her mouth. We had her blood work tested for Downs, but it came back normal. I've been told that a child's bridge of their nose needs to grow & the epicanthal folds will grow with the nose. I can send you a picture of my daughter. Can you tell me what you think?
Thank you
Posted Mon, 8 Oct 2012 in Child Health
Answered by Dr. Sumitra Kumar Mukherjee 39 minutes later

Thanks for the query.

The epicanthic fold is one of the presenting features in Down syndrome. You have already screened her to exclude Down syndrome. Therefore I think she is just a normal child with epicanthic fold. As the child grows nose bridge increases in height and epicanthic fold will simply disappear.

For those not genetically inclined towards this eye appearance like Mongolians. Thus in children of any race the fold is not necessarily suggestive of illness or medical condition.

Hope this answers your query.

Above answer was peer-reviewed by
Follow-up: 13 month child having epicanthal folds, and slight low muscle tone in mouth. What are the complications? 1 hour later

Thank you for your reply. Did you get a chance to look at her picture that I attached?

My daughter also has a fascination with her tongue - she likes to have the tip lying between her lips. When she was a baby, it would lay there about half the time. As she gets older, it's not as much but she still likes to have it lying between her lips. I think it's just something she does & it gives her comfort.

The pedi neurologist told us that the blood work is not 100% & if we wanted to go further she could order a micro-array test. My husband doesn't want to and I do.

In your years as a Pediatrician, have you seen children that had epicanthal folds as babies that grew out of them?

Thank you
Answered by Dr. Sumitra Kumar Mukherjee 53 minutes later
Dear Madam,

I was able to view the picture sent.

We think chromosomal study is the definite diagnostic tool for diagnosis of mongolism. Apart from that there are some physical characteristics usually present; e.g. Transverse palmer crease, hypotonia of muscles, protruded tongue, etc. I have seen one case who was diagnosed as mongal but later found to be perfectly normal and his epicanthic fold disappeared.

I hope I have given you all you wanted to know.

Kindest regards
Dr S.K.Mukherjee
Above answer was peer-reviewed by
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