Delayed nerve conduction velocities in children with protein-calorie malnutrition

Protein-calorie malnutrition in human beings and animals affects the myelination and growth of the nervous system. The effects of PCM on the developing nervous system were evaluated by measuring the nerve conduction velocities in 93 (38 marasmus, 13 kwashiorkor, and 42 control) children in ulnar, median, peroneal, and posterior tibial nerves. The children were divided into three age groups: Group I, six to 12 months; Group II, 13 to 24 months; Group III, 25 to 48 months. All 13 children with kwashiorkor demonstrated irritability, delayed milestones, and muscular wasting; and six also had hypoactive muscle reflexes. Conduction velocities were reduced in each type of malnutrition, with statistically significant differences in the three groups of marasmic children and in Group III kwashiorkor children. Children with kwashiorkor in Group II had significantly reduced velocities only in the nerves of the lower extremities. These data suggest PCM, when it occurs during the development of the nervous system, affects myelination of the peripheral nerves.