Introduction

Abstract

Parents of children born with mental or physical handicaps, tend to face the physician with questions about the origin of the abnormality concerned and the chance of having another child with the same condition. The physician then finds himself in a difficult situation since the causes of the majority of congenital abnormalities remain as yet unknown. In most cases he has to restrict himself to a mere enumeration of the signs and symptoms encountered or, at best, to a classification of the syndrome at hand. Efforts are frequently made to connect both the somatic aberrations and the mental deficiency with complications during the later stages of pregnancy, at the time of delivery or in the immediate postnatal period. However, a careful search for such items as abnormal dermatoglyphs, or ‘degenerative stigmata’, and, in particular, a post-mortem examination of the brain, often indicates that the handicap concerned should be ascribed to factors operating long before the time of birth.