Adrenal disorders and the paediatric brain: pathophysiological considerations and clinical implications

Area of Science:

• Pediatric Endocrinology
• Pediatric Neurology
• Neuroendocrinology

Background:

• Adrenal disorders in children are linked to various neurological and psychiatric symptoms.
• The developing central nervous system (CNS) is particularly sensitive to adrenal hormone imbalances.
• Literature review and case studies highlight the impact of glucocorticoids, mineralocorticoids, and catecholamines on the pediatric nervous system.

Purpose of the Study:

• To review the pathophysiological and clinical implications of adrenal disorders on the pediatric nervous system.
• To emphasize the vulnerability of the developing brain to adrenal hormone perturbations.
• To inform clinicians about potential neurological manifestations in children with adrenal dysfunction.

Main Methods:

• Literature review
• Analysis of personal case studies and case series
• Synthesis of existing research on adrenal disorders and neurological outcomes in children

Main Results:

• Childhood Cushing syndrome can cause lasting cognitive deficits and behavioral issues.
• Exogenous glucocorticoid excess in children may lead to neurological and MRI abnormalities, including delayed myelination and brain atrophy.
• Adrenal dysfunction is associated with idiopathic intracranial hypertension and hypertension-related neurological issues.

Conclusions:

• Adrenal hormone imbalances significantly affect pediatric CNS development and function.
• The pediatric brain is uniquely vulnerable to corticosteroids and adrenal disorders.
• Awareness and timely diagnosis of neurological manifestations in children with adrenal dysfunction are crucial for effective management.