A 3-year-old child from a goiter-endemic hilly district has deaf-mutism, intellectual disability, squint, spastic diplegia, and short stature. His mother had a large nodular goiter throughout pregnancy. Serum TSH is high and T4 is low. Which of the following best describes this condition?

• A Myxedematous cretinism due to postnatal iodine deficiency
• B Pendred syndrome
• C Neurological cretinism due to maternal iodine deficiency in early pregnancy ✓
• D Congenital thyroid dysgenesis

Explanation

Neurological cretinism results from severe maternal iodine deficiency in the first trimester, impairing fetal brain development while somatic development continues relatively normally. It features deaf-mutism, squint, spastic diplegia, and intellectual disability, typically without severe hypothyroidism at birth. Myxedematous cretinism instead shows marked growth failure, coarse skin, and persistent hypothyroidism, and lacks the dominant neuromotor picture seen here.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.