Neuroimaging (MRI) in Children with Microcephaly and Severe Acute Malnutrition

To study the change in brain by neuroimaging (MRI brain) in children with microcephaly and severe acute malnutrition aged 1 month to 60 months.

Children attending Bal Chikitsalaya, Maharana Bhupal Goverment Hospital, RNT Medical College, Udaipur (Rajasthan) were evaluated as per protocol. Microcephaly was defined as head circumference (HC) less than 3 SD or Z score <-3. Nutrition status of microcephaly children was recorded using weight for height criteria. Change in brain was evaluated by neuroimaging (MRI).

65 children with microcephaly and SAM were enrolled in the study. 38(58.46%) were male and 27(41.54%) were female. Male to female ratio was 1.41: 1. Most children presented with developmental delay 64(98.46%), abnormal tone 46(70.77%), convulsion 9(16.98%), regression of mile stone 5(7.69%) and tremor 5(7.69%). Anaemia was present in 62(95.38%) children. Among these children, TMBE 4(44.44%) was most common cause of convulsion followed by malaria 2(22.22%), hypocalcemia 2(22.22%) & pyogenic Meningitis 1(11.11%). The most frequent MRI findings were cerebral atropy in 42(64.62%) cases followed by finding of TBME with diffuse cerebral atropy in 5(7.69%), diffuse cerebral atropy with periventricular leucomalacia in 2(3.08%), diffuse cerebral atropy with delayed myelination in 1(1.54%), hypomyelination/delayed myelination in 1(1.54%), leucomalacia with delayed myelination in 1(1.54%) and periventricular leucomalacia in 1(1.54%).

Most children with Microcephaly and SAM had developmental delay, anaemia, abnormal tone, regression of mile stone and convulsion. Cerebral atrophy was most frequent finding on neuroimaging (MRI).