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Reversible neuromuscular syndrome in malnourished children
1Department of Neurology, Cornell University Medical College.
Insights
Malnutrition in children can cause reversible muscle weakness and absent reflexes. Adequate nutrition improved neurological function and strength, indicating a temporary lower motor neuron or muscle disorder.
Area of Science:
- Pediatric Neurology
- Clinical Electrophysiology
Background:
- Malnutrition in young children can present with neurological deficits.
- Understanding the impact of nutritional status on neuromuscular function is crucial.
Observation:
- Six malnourished children exhibited hypotonia, weakness, and absent reflexes (proximal and distal).
- Sensory examinations and nerve conduction studies were normal.
- Electromyography showed mild abnormalities in five children.
Findings:
- Neurological function and muscle strength significantly improved after nutritional rehabilitation.
- Weight-for-height ratio correlated with the presence/absence of reflexes.
- Reversible neuromuscular impairment was observed.
Implications:
- Suggests a reversible lower motor neuron or muscle disorder linked to malnutrition.
- Highlights the importance of nutritional status in pediatric neuromuscular health.
- Emphasizes the potential for recovery with adequate nutritional support.
Abstract:
Six young children are reported who were malnourished, with hypotonia, weakness and absent stretch reflexes, both proximally and distally, but with normal sensory examinations. Motor and sensory nerve conduction velocities also were normal. Five had mildly abnormal electromyograms, with scattered fibrillations, positive sharp waves and increased insertional activity, both proximally and distally. After adequate nutrition in hospital, all the children's reflexes returned and strength improved. Weight for height was an important indicator: it was decreased when the muscle stretch reflexes were absent and increased when they returned. The neurological and electrodiagnostic findings imply that this is a reversible lower motor-neuron or muscle disorder.