Autosomal recessive primary microcephaly is a genetic condition where a baby is born with a head size that is much smaller than expected for age and sex. The small head reflects a smaller brain, mostly because fewer brain cells were made during pregnancy. This happens very early in fetal life, when nerve-cell “factory” cells in the brain divide and make new neurons. In MCPH, many of the genes that control this cell division and the building of tiny cell parts called centrosomes do not work properly. As a result, the brain—especially the cerebral cortex—has less tissue and simpler folds (gyri) than usual. Most children have some level of learning and developmental delay; some also have seizures or movement problems, but many have otherwise normal growth of height and weight. MCPH is usually inherited in an autosomal recessive way: a child is affected when they receive one non-working copy of a gene from each parent. Frontiers+2MedlinePlus+2
Other names
Doctors and researchers may use these names for the same condition:
Primary microcephaly
Microcephaly primary hereditary (MCPH)
Isolated congenital microcephaly (when no other major body problems are present)
MCPH + a gene name (for example, ASPM primary microcephaly or WDR62 primary microcephaly)
These terms all point to the same core idea: a small head from birth due to fewer neurons made during brain development, most often from autosomal recessive gene changes. MedlinePlus+1
Types
There are many genetic “types” of MCPH. Each type is linked to a different gene. Historically they were numbered (MCPH1, MCPH2, …), and today over two dozen genes are known. The two most common are ASPM (MCPH5) and WDR62 (MCPH2). Others include MCPH1, CDK5RAP2 (MCPH3), CASC5/KNTC1 (MCPH4), CENPJ (MCPH6), STIL (MCPH7), CEP135 (MCPH8), PHC1 (MCPH9), ZNF335 (MCPH10), CEP152 (MCPH9/related), MFSD2A, SAS6, SLC45A2, and more being discovered. What they share is a role in centrosomes, spindles, DNA damage response, or cell-cycle control in neural stem cells. PMC+2NCBI+2
Key point: In many cohorts, ASPM is the most frequent cause, followed by WDR62; older and newer reviews vary on exact percentages because they depend on the population studied. PMC+1
Causes
Each “cause” below is a gene where having two harmful variants (one from each parent) can lead to MCPH. For each, you’ll see a short plain-English description of what goes wrong.
ASPM (MCPH5) – Helps build the spindle that pulls chromosomes apart during cell division. Faulty ASPM slows or spoils division of brain stem cells, so fewer neurons are made. It is the most commonly affected gene worldwide in MCPH. NCBI+1
WDR62 (MCPH2) – A centrosome-associated protein needed for correct spindle assembly and for guiding newborn neurons to the right place. Errors cause fewer divisions and migration problems, often with “simplified” brain folds on MRI. NCBI+1
MCPH1 (Microcephalin) – Coordinates DNA damage response and cell-cycle timing. When defective, neural stem cells stop dividing too soon or die, shrinking the cortex. PMC
CDK5RAP2 – Anchors and organizes centrosomes so spindles form correctly. Faults reduce accurate neuron production. PMC
CENPJ – A core centriole-building protein; defects impair centriole duplication, reducing the “machinery” for cell division in neural precursors. PMC
STIL – Controls centriole biogenesis; loss disrupts spindle formation and neural stem-cell proliferation. PMC
CEP135 – A centriole structural protein; damaging variants weaken centrosome function and neural progenitor divisions. PMC
CEP152 – Positions and duplicates centrioles; problems here limit the number of active centrosomes for mitosis in neural cells. PMC
CASC5 (KNTC1) – A kinetochore protein crucial for equal chromosome separation; errors trigger cell-cycle arrest or death of dividing brain cells. PMC
PHC1 – Part of the polycomb group complex that regulates genes during development; disruption alters neural stem-cell self-renewal. PMC
ZNF335 – A neuron differentiation regulator; faulty ZNF335 disturbs the switch from proliferation to maturation, shrinking cortex size. PMC
MFSD2A – A lipid transporter essential for bringing DHA (an omega-3 fat) into the brain; biallelic variants can cause microcephaly with brain growth failure. PMC
PLK4 – A master regulator of centriole duplication; reduced activity lowers centriole numbers and mitoses in neuroprogenitors. PMC
SAS6 (HSPD6) – Initiates building the nine-fold symmetry of centrioles; loss leads to defective mitotic apparatus in neural stem cells. PMC
WDFY3 – Involved in autophagy and neurodevelopment; variants reported with primary microcephaly phenotypes in some families. PMC
RRP7A – Ribosome biogenesis factor; faulty ribosome assembly can selectively reduce neural progenitor growth. PMC
CIT (Citron kinase) – Coordinates the final “pinch” step of cell division (cytokinesis); failure causes neural cell loss. PMC
KIF14 – A motor protein for chromosome movement and cytokinesis; harmful variants reduce brain cell numbers. PMC
SLC45A2 – Mostly known for pigmentation; rare reports link biallelic variants with MCPH-like microcephaly in specific cohorts. Mechanism may involve linked pathways or locus complexity. PMC
Additional rare genes (e.g., ANKLE2, NCAPD2/3) – Emerging studies add genes of chromosome condensation and nuclear-envelope biology; all converge on the same theme: impaired division of neural stem cells → fewer cortical neurons. PMC
Note: The exact “top three” by frequency vary by region and by study design. Many cohorts still find ASPM most common, followed by WDR62 and MCPH1, but newer series in specific populations can flip the order. PMC+1
Symptoms and everyday signs
Small head from birth – Head circumference is below the normal range right away; by age 1, it is usually more than 3 standard deviations below average. Parents first notice it when the baby’s head seems small compared to peers. NCBI
Small brain size on imaging – Brain MRI shows a smaller brain volume; the cerebral cortex often has fewer or simpler folds (“simplified gyral pattern”). NCBI
Developmental delay – Milestones like sitting, walking, and talking may come later than usual. The delay ranges from mild to severe. Frontiers
Learning difficulties/intellectual disability – Most children need extra help at school and with daily tasks; the degree varies even within the same gene. Frontiers+1
Speech and language delay – First words and sentences may be late; speech therapy often helps. Frontiers
Motor coordination difficulties – Some children have clumsiness or poor fine-motor control, reflecting fewer or less connected neurons. Frontiers
Seizures (sometimes) – A minority develop epilepsy; an EEG can help if there are spells of staring, jerks, or loss of awareness. Frontiers
Behavior differences – Some children show hyperactivity, attention problems, or autistic features; these vary widely. Frontiers
Normal height and weight in many cases – Outside the brain, many children grow normally; microcephaly is the main finding (“isolated”), though exceptions exist. MedlinePlus
Facial appearance can look proportionate – The face often looks typical and the body looks proportionate; the head just measures small compared to charts. MedlinePlus
Mild spasticity or tone changes (some) – A few children have increased or decreased muscle tone, which can affect walking. NCBI
Feeding or sucking issues in infancy (some) – Especially if tone is low or coordination is poor; these tend to improve with therapy. Frontiers
Vision or eye-movement issues (some) – Strabismus or tracking problems can occur in subsets depending on the gene. NCBI
Hearing is usually normal – Hearing loss is not a core feature; check if there are concerns, but most children hear normally. MedlinePlus
Stable or non-progressive course – Head size difference is present from birth; the condition usually does not “degenerate” over time, although support needs change with age. Frontiers
Diagnostic tests
A. Physical examination
Serial head-circumference (OFC) measurements – The clinician measures the head with a tape at every visit and plots it on standardized growth charts by sex and ethnicity. Persistently very low OFC confirms true microcephaly. MedlinePlus
Full growth assessment – Height, weight, and BMI are checked. In primary microcephaly, these are often in the normal range, helping separate MCPH from syndromes with global growth failure. MedlinePlus
Neurologic exam – Tone, reflexes, strength, coordination, and cranial nerves are examined to look for spasticity, hypotonia, or asymmetries that may point to complications like seizures. Frontiers
Dysmorphology check – The clinician looks for unusual facial or body features. Primary microcephaly is typically “isolated,” so major anomalies are limited; this helps distinguish MCPH from broader syndromes. Orpha
Developmental screening – Short bedside tools (e.g., milestone checklists) flag delays in motor, language, and social skills and guide referrals for therapies. Frontiers
B. Manual/bedside tests
Repeat OFC by a second measurer – Simple but important: repeating the head measurement avoids errors and confirms severity. MedlinePlus
Standardized developmental evaluation – A structured play-based exam by therapists or psychologists gives baseline scores for motor, language, and cognition. This helps track progress over time. Frontiers
Vision screening – Light tracking and fixation tests (and later chart-based tests) check for strabismus or visual processing issues that can affect learning. NCBI
Hearing screening – Otoacoustic emissions or audiometry (age-appropriate) ensure that speech delay is not from hearing loss. Most MCPH children pass, but it is good practice to check. MedlinePlus
Seizure first-aid review and event diary – Families are taught how to record spells and triggers, helping decide whether EEG is needed. Frontiers
C. Laboratory and pathological tests
Targeted multigene panel for microcephaly – A blood test sequences many MCPH genes at once (for example, ASPM, WDR62, MCPH1, CDK5RAP2, etc.). This is the most efficient starting test in many settings. NCBI
Whole-exome or whole-genome sequencing – Used when panel testing is negative or when features are atypical. It can detect rare or newly discovered genes. Frontiers
Chromosomal microarray – Screens for deletions/duplications across the genome; helpful if the presentation suggests a broader genomic syndrome or if sequencing is inconclusive. Orpha
Parental carrier testing – Confirms autosomal recessive inheritance by identifying the same variants in each parent, which supports accurate recurrence counseling. MedlinePlus
Rule-out tests for secondary causes – If history suggests infection or exposure (for example, Zika infection in pregnancy), serologies or specific labs are considered to ensure the microcephaly is truly “primary.” Orpha
D. Electrodiagnostic tests
EEG (electroencephalogram) – Measures brain electrical activity if there are suspected seizures or staring spells. It can guide treatment decisions. Frontiers
Video-EEG monitoring (if needed) – Prolonged recording helps catch rare or subtle events and link them to behavior. This is used when routine EEG is unclear. Frontiers
Evoked potentials (selected cases) – Visual or auditory evoked potentials can document sensory pathway function if visual or hearing behaviors are hard to interpret. NCBI
E. Imaging tests
Prenatal ultrasound – In late second or third trimester, ultrasound can show a small head size compared with body size, raising concern and prompting genetic counseling and testing. Orpha
Prenatal fetal MRI (selected cases) – Gives more detail on brain structure and cortical development when ultrasound is concerning. It helps families prepare and informs delivery planning. Orpha
Postnatal brain MRI – The key imaging test after birth; it shows overall small brain volume and often a simplified gyral pattern without major malformations, supporting the diagnosis of primary microcephaly. NCBI
Cranial ultrasound (newborns) or head CT (if MRI not possible) – Ultrasound can screen in the NICU; CT is avoided when possible due to radiation but may be used in emergencies. Orpha
Non-pharmacological treatments (therapies & supports)
Early Intervention (EI)
Description/Purpose: EI provides speech, physical, and occupational therapy from birth to 3 years to build skills early. Mechanism: Repeated, play-based practice strengthens pathways for motor, language, and social learning when the brain is most flexible (neuroplastic). CDC+1Individualized Special Education
Description/Purpose: School plans tailor teaching, supports, and accommodations to the child’s level. Mechanism: Structured learning, repetition, and visual supports help consolidate memory and attention in small steps. Pediatrics in ReviewSpeech-Language Therapy (including AAC)
Description/Purpose: Builds understanding, speech, and alternative ways to communicate (pictures, tablets). Mechanism: Modeling and aided language input increase opportunities to communicate; AAC can boost participation and does not “block” speech. ASHA+1Occupational Therapy (OT)
Description/Purpose: Improves daily living skills (feeding, dressing, play) and fine motor control. Mechanism: Task-specific practice + adaptive tools reduce effort and build independence through motor learning. Pediatrics in ReviewPhysical Therapy (PT)
Description/Purpose: Works on strength, balance, posture, and walking patterns. Mechanism: Repetition of targeted movements reshapes motor control and prevents contractures. Pediatrics in ReviewBehavioral Supports (e.g., Functional Communication Training)
Description/Purpose: Replaces challenging behaviors with communication skills. Mechanism: Identifies function of behavior and teaches an easier, acceptable behavior that meets the same need. ASHASeizure First-Aid Training for Caregivers
Description/Purpose: Families learn how to keep a child safe during a seizure and when to call for help. Mechanism: Simple steps (protect head, turn on side, time the event) reduce injury and anxiety. CDC+1Feeding and Nutrition Support
Description/Purpose: Dietitians address poor weight gain, reflux, or unsafe swallowing; tube feeding may be needed. Mechanism: Consistent calories and safe textures support growth and brain health; G-tubes bypass unsafe swallowing. PMC+1Vision Care and Strabismus Management
Description/Purpose: Regular eye exams, glasses, and patching to optimize vision. Mechanism: Correcting refractive errors and alignment supports visual development and learning. AAPOSHearing Care
Description/Purpose: Screening and early amplification if needed. Mechanism: Improved hearing input supports speech and language growth. Pediatrics in ReviewSleep Hygiene Coaching
Description/Purpose: Set routines, light control, and calming steps to improve sleep. Mechanism: Strong circadian cues and consistent schedules reduce night waking and irritability. Pediatrics in ReviewAdaptive Seating and Mobility Aids
Description/Purpose: Seating systems, walkers, or orthoses to support safe posture and movement. Mechanism: Proper alignment reduces tone-related strain and prevents deformity. PMCCaregiver Training & Respite
Description/Purpose: Skills training and planned relief time for families. Mechanism: Lowers burnout and improves home carryover of therapies. CDCSafety Planning (Home/School)
Description/Purpose: Plans for seizures, wandering, and emergency steps. Mechanism: Pre-agreed actions reduce risk and response time. Epilepsy FoundationCommunication-Rich Home Program
Description/Purpose: Daily practice of simple signs/pictures in routines. Mechanism: High-frequency modeling accelerates language learning. ASHACognitive-Behavioral Strategies (older children)
Description/Purpose: Visual schedules, task breaking, and rewards. Mechanism: External structure supports attention and executive skills. Pediatrics in ReviewCommunity-Based Rehabilitation & Inclusion
Description/Purpose: Inclusive playgroups and community access. Mechanism: Social participation improves communication and behavior generalization. CDCGenetic Counseling for Families
Description/Purpose: Explains recurrence risks and testing options. Mechanism: Carrier testing, prenatal options, and PGT can reduce future affected pregnancies. NCBI+1Head-Growth & Milestone Monitoring
Description/Purpose: Regular head-circumference and development checks. Mechanism: Early detection of complications triggers timely supports. PMCCare Coordination (multidisciplinary clinic)
Description/Purpose: Neurology, genetics, rehab, nutrition, and education services in one plan. Mechanism: Team care reduces gaps and duplication, improving outcomes. Pediatrics in Review
Drug treatments
Important: These medicines treat problems associated with MCPH (like seizures, spasticity, ADHD symptoms, reflux, sleep issues). Doses must be individualized by clinicians. Always check the current FDA label. Pediatrics in Review
Levetiracetam (Keppra / Keppra XR / Spritam) – anti-seizure
Class/Purpose: Broad-spectrum antiseizure drug for focal and generalized seizures; often first-line in children. Typical dosing/time: Weight-based, divided twice daily (immediate-release) or once daily (XR). Mechanism: Modulates synaptic vesicle protein SV2A to reduce abnormal neuronal firing. Key adverse effects: Somnolence, irritability or mood changes; adjust in renal impairment. Evidence source: FDA labeling. FDA Access Data+2FDA Access Data+2Topiramate (Topamax) – anti-seizure
Class/Purpose: For focal and generalized seizures; may help migraines in older patients. Dosing/time: Slow titration to target; divided dosing or ER forms. Mechanism: Enhances GABA activity, blocks AMPA/kainate, and inhibits carbonic anhydrase. Side effects: Cognitive slowing, weight loss, paresthesias; kidney stone risk. Evidence source: FDA labeling. FDA Access Data+1Valproate/Valproic acid (Depacon/Depakote) – anti-seizure
Class/Purpose: Broad-spectrum antiseizure drug (avoid in girls who may become pregnant due to teratogenicity). Dosing/time: IV or oral; titrate to response and levels. Mechanism: Increases GABA, modulates sodium/calcium channels. Side effects: Hepatotoxicity, thrombocytopenia, pancreatitis, weight gain; strong pregnancy warnings. Evidence source: FDA labeling. FDA Access Data+1Clonazepam (Klonopin) – benzodiazepine for seizures/spasticity
Class/Purpose: Adjunct for certain seizure types and muscle tone issues. Dosing/time: Start low, divide 2–3 times daily; slow titration. Mechanism: GABA-A receptor potentiation reduces neuronal excitability. Side effects: Sedation, dependence, drooling, ataxia. Evidence source: FDA labeling. FDA Access Data+1Diazepam rectal gel (Diastat) – rescue for seizure clusters
Class/Purpose: Caregiver-administered rescue therapy for prolonged or cluster seizures. Dosing/time: Weight-based rectal dose at onset; follow label re-dosing limits. Mechanism: Rapid GABA-A potentiation aborts seizures. Side effects: Somnolence, respiratory depression if overdosed. Evidence source: FDA labeling. FDA Access Data+1Midazolam nasal spray (Nayzilam) – rescue for seizure clusters (≥12y)
Class/Purpose: Needle-free home rescue therapy. Dosing/time: 5 mg in one nostril; may repeat per label limits. Mechanism: Fast GABA-A modulation; quick mucosal absorption. Side effects: Sedation, respiratory depression with other CNS depressants. Evidence source: FDA labeling. FDA Access DataBaclofen (oral; brands like Lyvispah, Fleqsuvy, Ozobax) – spasticity
Class/Purpose: Reduces severe muscle stiffness that limits care and function. Dosing/time: Start low, divide 3–4 times daily; do not stop abruptly. Mechanism: GABA-B agonist reduces spinal reflex hyperexcitability. Side effects: Sedation, hypotonia; withdrawal can be dangerous. Evidence source: FDA labeling. FDA Access Data+2FDA Access Data+2OnabotulinumtoxinA (Botox) – focal spasticity management
Class/Purpose: Injected into overactive muscles to reduce tone and improve care or function. Dosing/time: Units per muscle every ≥12 weeks; ultrasound/EMG guidance improves accuracy. Mechanism: Blocks acetylcholine release at neuromuscular junction. Side effects: Local weakness; rare spread of effect. Evidence source: FDA labeling. FDA Access Data+1Methylphenidate ER (Concerta) – ADHD symptoms
Class/Purpose: Improves attention and hyperactivity where ADHD-like symptoms exist. Dosing/time: Morning once-daily ER tablets; monitor appetite/sleep. Mechanism: Blocks dopamine/norepinephrine reuptake in prefrontal circuits. Side effects: Appetite loss, insomnia, irritability; labeling updates caution in very young children. Evidence source: FDA labeling and recent FDA update reports. FDA Access Data+2FDA Access Data+2Clonidine ER (Kapvay) – non-stimulant for attention/sleep
Class/Purpose: Helps attention, impulsivity, and sleep onset in some children. Dosing/time: Night-weighted dosing common; taper slowly. Mechanism: Central α2-agonist lowers sympathetic tone, improving regulation. Side effects: Sleepiness, low blood pressure, dry mouth. Evidence source: FDA labeling. FDA Access Data+1Melatonin – sleep initiation (OTC supplement, not FDA-approved as a drug)
Class/Purpose: Supports sleep onset with consistent bedtime routine. Dosing/time: Low dose 30–60 minutes before bedtime. Mechanism: Mimics natural melatonin to cue circadian timing. Side effects: Morning sleepiness, vivid dreams. Evidence source: Pediatric care reviews. Pediatrics in ReviewAcid suppression (e.g., proton-pump inhibitors) when reflux impairs feeding
Class/Purpose: Improves comfort, weight gain, and therapy tolerance in children with significant GERD. Mechanism: Lowers gastric acid to reduce esophagitis and pain. Side effects: Diarrhea, rare nutrient effects with long use; use only when clearly indicated. Evidence source: Pediatric GI guidance. naspghan.org
(To keep this answer readable, I’ve shown a practical core set of medicines with FDA labels or pediatric guidance; your editorial team can add more antiseizure options—e.g., lamotrigine, oxcarbazepine, lacosamide, ethosuximide, rufinamide, clobazam, perampanel, cenobamate—using the same label-based template.) Pediatrics in Review
Dietary molecular supplements
Omega-3s (DHA/EPA)
Description/Dosage: DHA/EPA from fish or supplements can support general brain and eye development; typical pediatric amounts are individualized. Function/Mechanism: DHA is a key neuronal membrane component; adequate intake supports synaptic function and vision. Office of Dietary SupplementsVitamin D
Description/Dosage: Many children need supplementation to meet age-based needs and avoid deficiency; respect safe upper limits. Function/Mechanism: Supports bone health, muscle function, and possibly sleep and immunity. Office of Dietary Supplements+1Iron (when deficient)
Description/Dosage: Correct iron deficiency anemia per age/weight under supervision. Function/Mechanism: Restores hemoglobin and brain iron enzymes; deficiency in infancy is linked to lasting cognitive effects. Office of Dietary SupplementsIodine (adequate intake, especially pre-/perinatal)
Description/Dosage: Ensure iodized salt or prenatal iodine to meet daily needs. Function/Mechanism: Thyroid hormone production for fetal/infant brain development. Office of Dietary Supplements+1Choline
Description/Dosage: Ensure dietary choline (eggs, meats, legumes) or supplements if advised. Function/Mechanism: Membrane phospholipids and acetylcholine for memory and motor control; key in early brain development. Office of Dietary SupplementsZinc (if deficient)
Description/Dosage: Replace documented deficiency only. Function/Mechanism: Cofactor in DNA/RNA synthesis and immune function—important during rapid growth. Office of Dietary SupplementsFolate (if deficient)
Description/Dosage: Age-appropriate folate via diet or supplements as guided. Function/Mechanism: One-carbon metabolism for neural tissue growth. Office of Dietary SupplementsVitamin B12 (if deficient)
Description/Dosage: Replace deficiency, especially in low-animal-product diets. Function/Mechanism: Myelin and neuronal function. Office of Dietary SupplementsCalcium (dietary adequacy)
Description/Dosage: Ensure sufficient intake alongside vitamin D. Function/Mechanism: Bone mineralization and neuromuscular signaling. Office of Dietary SupplementsProtein-energy supplements (medical nutrition)
Description/Dosage: High-calorie formulas or tube feeds for poor growth. Function/Mechanism: Meets energy/protein needs to support therapy gains. naspghan.org
Immunity booster / regenerative / stem-cell drugs
There are no approved immune-boosting, regenerative, or stem-cell drugs for MCPH. Stem-cell or gene-targeted approaches are research concepts without approved pediatric dosing or proven clinical benefit for MCPH today. Families should avoid unregulated “stem-cell” clinics. Care remains supportive, focusing on development, seizure control, nutrition, and inclusion. (For intractable epilepsy, vagus nerve stimulation is an FDA-approved device option—not a drug.) PMC+1
Surgeries / procedures
Gastrostomy (G-tube) placement
Why done/Procedure: For unsafe swallowing or poor weight gain, a feeding tube through the abdomen provides reliable nutrition; placed endoscopically or surgically. PMC+1Vagus Nerve Stimulation (VNS) implant for drug-resistant epilepsy
Why done/Procedure: A pacemaker-like device stimulates the vagus nerve to reduce seizure frequency; outpatient surgery with chest/neck leads; programming follows. FDA Access Data+1Orthopedic procedures for spasticity/contractures
Why done/Procedure: Tendon lengthening or hip reconstruction improves positioning, hygiene, and comfort when tone causes deformity. PMCStrabismus surgery
Why done/Procedure: Eye-muscle surgery can improve alignment, depth cues, and social interaction when glasses/therapy are not enough. AAPOSGastrojejunostomy tube conversion
Why done/Procedure: For severe reflux or aspiration with gastric feeds, a tube into the small bowel allows continuous safer feeding. naspghan.org
Preventions
Genetic counseling for parents/sibs to explain recurrence risk and options. NCBI
Carrier testing of at-risk relatives when the family variants are known. NCBI
Prenatal testing (CVS/amniocentesis) for known familial variants. NCBI
Preimplantation genetic testing (PGT-M) during IVF to select embryos without the pathogenic variants. NCBI
Consanguinity counseling to discuss higher recessive risk. PubMed
Optimize maternal nutrition (iodine, iron, folate, choline, omega-3s) before and during pregnancy. Office of Dietary Supplements+3Office of Dietary Supplements+3Office of Dietary Supplements+3
Routine newborn hearing/vision screening to catch treatable problems early. Pediatrics in Review
Early developmental monitoring (CDC checklists) to trigger EI fast. CDC
Seizure safety education for families and schools. CDC
Vaccinations and infection prevention to avoid setbacks in vulnerable children. Pediatrics in Review
When to see doctors (red flags)
See your pediatrician/neurologist urgently for: new or prolonged seizures; loss of skills; poor feeding, choking, or weight loss; repeated chest infections; worsening stiffness or pain; eye crossing or vision loss; hearing concerns; persistent poor sleep that affects daytime function; or major behavior changes. Regular visits track head growth, milestones, nutrition, vision/hearing, and therapy goals. Pediatrics in Review+1
Foods to favor & to limit
Eat more: iron-rich foods (lean meats/legumes), fortified cereals, eggs (choline), dairy or calcium-fortified alternatives, fish 1–2×/week (DHA), colorful fruits/veggies, whole grains, nut/seed butters (if safe), iodized-salt-seasoned home foods, and high-calorie shakes if growth is poor (guided by dietitian). naspghan.org+3Office of Dietary Supplements+3Office of Dietary Supplements+3
Limit: very low-nutrient ultra-processed snacks, sugary drinks, excessive juice, energy drinks/caffeine, high-sodium instant foods (if on antihypertensives like clonidine), choking-risk textures if dysphagia, “mega-dose” vitamins without labs, herbal products promising “brain growth,” and any unregulated stem-cell/“regenerative” products. Office of Dietary Supplements+1
FAQs
1) Is there a cure for MCPH?
No disease-modifying therapy exists yet; treatment focuses on development, seizure control, nutrition, and inclusion. Pediatrics in Review
2) Will head size catch up?
Head growth continues but remains below average; progress is in skills, not head size. Pediatrics in Review
3) Can my child learn to talk?
Many children communicate better with speech therapy and AAC supports, even if speech is limited. ASHA
4) Do seizures always occur?
Not always; if present, modern anti-seizure medicines and rescue plans can help. CDC
5) Which anti-seizure drug is “best”?
Choice is individualized based on seizure type, age, side-effect profile, and comorbidities; levetiracetam and topiramate are common options. FDA Access Data+1
6) Is valproate safe?
It’s effective but has serious risks (liver, blood, pregnancy); specialists weigh risks vs benefits carefully. FDA Access Data
7) What if medicines don’t control seizures?
Rescue therapies (diazepam rectal gel, midazolam nasal) and VNS may be considered for refractory cases. FDA Access Data+2FDA Access Data+2
8) Will therapies really help?
Yes—early, frequent, goal-directed therapies improve function and participation. CDC
9) Should we test genes?
Genetic testing confirms cause, guides counseling, and may open research/trial options. NCBI
10) Can we prevent this in future pregnancies?
Carrier testing, prenatal diagnosis, and PGT-M during IVF are options for known familial variants. NCBI
11) Are special diets needed?
No specific “microcephaly diet,” but adequate calories and key micronutrients matter; a dietitian can tailor plans. naspghan.org
12) Are supplements required?
Only if deficient or advised (e.g., iron, vitamin D, iodine, choline, omega-3s). Avoid megadoses. Office of Dietary Supplements+1
13) Is surgery common?
Most children don’t need surgery; G-tube, orthopedic, or eye surgery/VNS are used for specific problems. PMC+2PMC+2
14) Does small head mean severe disability?
Outcomes vary widely; supports, environment, and early therapies make a real difference. Pediatrics in Review
15) Where can families learn more?
Trusted overviews: AAP materials, GARD/NIH, Orphanet, and GeneReviews for gene-specific details. Pediatrics in Review+2Genetic Rare Diseases Center+2
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members
Last Updated: October 13, 2025.
