Identifying Clinical Clues in Children With Global Developmental Delay / Intellectual Disability With Abnormal Brain...

Area of Science:

• Pediatric Neurology
• Neuroimaging
• Developmental Pediatrics

Background:

• Global developmental delay/intellectual disability are common pediatric conditions requiring diagnostic evaluation.
• Brain MRI is crucial but often necessitates general anesthesia, posing potential neurodevelopmental risks in young children.
• Avoiding unnecessary anesthesia exposure is recommended due to potential long-term negative neurodevelopmental sequelae.

Purpose of the Study:

• To identify clinical clues associated with brain MRI abnormalities in children diagnosed with global developmental delay/intellectual disability.
• To guide physicians in selecting pediatric patients who would most benefit from a brain MRI.
• To reduce unnecessary anesthesia exposure in children undergoing neuroimaging.

Main Methods:

• Retrospective chart review of pediatric neurology patients evaluated for global developmental delay/intellectual disability between 2014-2017.
• Analysis of detailed clinical history and physical examination findings correlated with brain MRI results.
• Statistical analysis to determine significant correlations between clinical features and MRI abnormalities.

Main Results:

• Abnormal brain MRI findings were present in 70% of evaluated children.
• White matter, corpus callosum, and hippocampus abnormalities were most prevalent.
• Clinical features significantly associated with MRI abnormalities included predominant motor delay, cognitive disability, visual/hearing impairment, facial dysmorphisms, cranial nerve abnormalities, and abnormal reflexes.

Conclusions:

• Clinical assessment can identify children with global developmental delay/intellectual disability who are more likely to have abnormal brain MRI findings.
• Specific examination findings like facial dysmorphisms and abnormal reflexes are strong predictors of MRI abnormalities.
• This approach can aid in judiciously selecting patients for brain MRI, potentially minimizing risks associated with anesthesia.