Reassessment of Patients With the Diagnosis of Fetal Alcohol Syndrome

To the Editor. The diagnosis of fetal alcohol syndrome (FAS) is clinical, based on a pattern of craniofacial features, growth retardation, microcephaly, and neurologic effects (along with a history of exposure).1 We present several patients originally diagnosed with FAS (on the basis of unusual facial features, developmental problems, and a history of maternal alcohol abuse) who had another underlying condition. Patient 1 was the 2.5-kg product of a 37-week pregnancy to a woman with a history of alcoholism, cleft palate, and learning difficulties. His past medical history was notable for tetralogy of Fallot, palatal incoordination, and speech delay. At age 10 his weight and height were at the 25th percentile and head circumference was at the 50th to 75th percentile. He …