MULTIHANDICAPPED BLIND AND PARTIALLY SIGHTED CHILDREN IN SOUTH GERMANY .2. ETIOLOGY AND PATHOGENESIS

The results of a classification of the aetiology of visual impairment and mental retardation in a series of 239 multihandicapped blind and p artially sighted children are reported. These children had been born b etween 1981 and 1987 and were examined in a population-based study in South Germany. There was marked aetiological heterogeneity. Most promi nent were causes related to the perinatal period and late gestation wh ich were found in 41% of the children. Among these, lesions of the vis ual pathways in preterm children were especially frequent and could be explained by periventricular leukomalacia in a large proportion. The distribution of the major aetiologic groups is different from populati ons with isolated mental retardation and populations with isolated vis ual impairment but similar to a Swedish population with spastic quadri plegia. The implications for the prevention of severe multiple impairm ents in children are discussed.