Moreover, findings from a cross-sectional study suggest that children with developmental dyscalculia might have a delayed development in their numerical magnitude representation by as much as five years. However, the lack of longitudinal studies still leaves the question open as to whether the deficient numerical magnitude representation is a delayed development or impairment. Access deficit hypothesis
Rousselle & Noël propose that dyscalculia is caused by the inability to map preexisting representations of numerical magnitude onto symbolic Arabic digits. Evidence for this hypothesis is based on research studies that have found that individuals with dyscalculia are proficient on tasks that measure knowledge of non-symbolic numerical magnitude (i.e., non-symbolic comparison tasks) but show an impaired ability to process symbolic representations of number (i.e., symbolic comparison tasks). Neuroimaging studies also report increased activation in the right intraparietal sulcus during tasks that measure symbolic but not non-symbolic processing of numerical magnitude. However, support for the access deficit hypothesis is not consistent across research studies. Diagnosis
At its most basic level, dyscalculia is a learning disability affecting the normal development of arithmetic skills.A consensus has not yet been reached on appropriate diagnostic criteria for dyscalculia. Mathematics is a specific domain that is complex (i.e. includes many different processes, such as arithmetic, algebra, word problems, geometry, etc.) and cumulative (i.e. the processes build on each other such that mastery of an advanced skill requires mastery of many basic skills).
Depending on the size of the tumor and how much of it is removed, studies show that 20 to 50% will recur, usually within five years. Prognosis
People with microprolactinoma generally have an excellent prognosis. In 95% of cases, the tumor will not show any signs of growth after a 4 to 6-year period.Macroprolactinomas often require more aggressive treatment otherwise they may continue to grow. There is no way to reliably predict the rate of growth, as it is different for every individual. Regular monitoring by a specialist to detect any major changes in the tumor is recommended. Osteoporosis risk
Hyperprolactinemia can cause reduced estrogen production in women and reduced testosterone production in men. Although estrogen/testosterone production may be restored after treatment for hyperprolactinemia, even a year or two without estrogen/testosterone can compromise bone strength, and patients should protect themselves from osteoporosis by increasing exercise and calcium intake through diet or supplementation, and by avoiding smoking. Patients may want to have bone density measurements to assess the effect of estrogen/testosterone deficiency on bone density. They may also want to discuss testosterone/estrogen replacement therapy with their physician. Pregnancy and oral birth control
If a woman has one or more small prolactinoma, there is no reason that she cannot conceive and have a normal pregnancy after successful medical therapy. The pituitary enlarges and prolactin production increases during normal pregnancy in women without pituitary disorders. Women with prolactin-secreting tumors may experience further pituitary enlargement and must be closely monitored during pregnancy.