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Reversible cerebral shrinkage in kwashiorkor: an MRI study
G D Gunston1, D Burkimsher, H Malan
1Department of Paediatrics, Red Cross War Memorial Children's Hospital, University of Cape Town, Republic of South Africa.
Archives of Disease in Childhood
|August 1, 1992
Summary
Protein energy malnutrition causes brain atrophy in children with kwashiorkor. Nutritional rehabilitation rapidly reverses these cerebral changes, improving brain structure and function.
Area of Science:
- Neurology
- Pediatrics
- Nutritional Science
Background:
- Protein energy malnutrition, particularly kwashiorkor, is linked to cerebral atrophy.
- Cerebral atrophy can negatively impact intellectual development in affected children.
Purpose of the Study:
- To document anatomical abnormalities causing cerebral atrophy in kwashiorkor using MRI.
- To monitor the resolution of these brain changes during nutritional rehabilitation.
Main Methods:
- Magnetic resonance imaging (MRI) of the brain was performed on 12 children with kwashiorkor.
- Children were assessed clinically, biochemically, and via MRI at admission, and at 30 and 90 days post-admission.
Main Results:
- All children exhibited brain shrinkage on admission.
- White and grey matter were equally affected; myelination was age-appropriate.
- Cerebral changes resolved in 9 children and improved in the remaining 3 by day 90.
Conclusions:
- Kwashiorkor-associated brain shrinkage is reversible with nutritional rehabilitation.
- Rapid recovery of cerebral structure is observed with improved nutritional status.