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Zoey's work up

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Hi April, Meg Hefner, genetic counselor here. I've been following the

information on Zoey and thought I should pipe up. I usually wait until

parents have sent messages, as they know lots and lots about CHARGE and

are often the best at passing on relevant information.

Making a diagnosis of CHARGE is not as straightforward as it might

seem. In fact, I have just this week been involved in further

discussions about what a child must have to get a diagnosis of

" definite " CHARGE. The bottom line is to have definite CHARGE, a child

has to have two of the four " major " features. Those major features are

Coloboma

Choanal atresia

Cranial nerve abnormality (facial palsy, lack of smell, and/or

swallowing difficulty)

Characteristic CHARGE ear

Only about half of children with CHARGE have choanal atresia or

stenosis. Stenosis is just narrowing of the passages (and it can be

one-sided) - that can be VERY difficult to detect in some cases. Facial

palsy and swallowing problems are usually pretty obvious, but lack of

sense os smell can be extremely difficult to determine in someone who is

not yet communicating.

Based on what you have said so far, I would keep Zoey at least in the

" probable/possible " CHARGE category - meaning she should be carefully

evaluated for potential features of CHARGE. Probably the most important

thing to check out that you haven't mentioned is kidneys. 30-40% of

kids with CHARGE have something going on with their kidneys - some more

serious than others.

What geneticist did you see, at what medical facility (where do you

live)? Has Zoey ever had feeding problems? Does she have facial

palsy? I would love to see photos - of face and ears, especially.

Actually, everyone likes to see photos - you can post them at the

yahoogroups site (they won't come through to the listserv - attachments

are deleted due to virus concerns) or you could send them directly to me

at meg@...

No matter what any geneticists say, if this list and the CHARGE

Foundation are helpful to you, stick with us. And with colobomas and

hearing loss, I can almost guarantee this CHARGE family will be helpful

for you. Let me know if you have other questions for me. And welcome

to you and your family!

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