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Muscle complications of malnutrition in children: a clinical and electromyographic study
1Laboratoire de neurophysiologie clinique de l'enfant, hôpital Armand-Trousseau, Paris, France.
Insights
Electromyography (EMG) reveals muscle abnormalities in children with malnutrition-related motor deficits. This diagnostic tool aids in identifying the myopathic cause of weakness in undernourished or chronically ill children.
Area of Science:
- Pediatric Neurology
- Clinical Electrophysiology
- Nutritional Neuroscience
Background:
- Malnutrition, particularly protein-calorie deficiency, can lead to significant motor deficits in children.
- These deficits may present as pseudomyopathic symptoms, mimicking primary muscle disorders.
- Accurate etiological diagnosis is crucial for appropriate management and intervention.
Purpose of the Study:
- To investigate the clinical and electromyographic (EMG) findings in children with pseudomyopathic motor deficits associated with malnutrition.
- To evaluate the utility of EMG in diagnosing the underlying myopathic process in this population.
- To correlate EMG findings with clinical presentation and muscle biopsy results.
Main Methods:
- Retrospective analysis of 13 children with Body Mass Index (BMI) < or = 3rd percentile.
- Clinical assessment of motor abilities, muscle tone, and strength.
- Electromyography (EMG) including detection and stimulation-detection techniques.
- Muscle biopsy in five cases.
Main Results:
- All patients exhibited myogenic signs on EMG, predominantly in proximal muscles.
- Infants showed motor regression/stagnation, hypotonia, and amyotrophy; older children had proximal muscle weakness.
- EMG revealed slowed motor nerve conduction velocities in some cases and temporal dispersion of motor responses.
- Muscle biopsies showed fiber size inequality, with type II fiber atrophy.
Conclusions:
- EMG is a valuable tool for identifying myopathic processes in children with malnutrition-induced motor deficits.
- EMG findings contribute significantly to the etiological diagnosis of motor impairment in undernourished or chronically ill children.
- Early detection of myopathy through EMG can guide targeted therapeutic strategies.
Abstract:
The authors report the clinical and electromyographic (EMG) findings in a series of 13 children with a pseudomyopathic motor deficit in the context of malnutrition (Body Mass Index < or = 3rd percentile) caused by primary protein-calorie deficiency or secondary to chronic disease. The infants (nine cases) manifested a regression or stagnation of motor abilities, with hypotonia and amyotrophy; older children and adolescents (four cases) presented clear amyotrophy with a deficit in muscle strength consisting primarily of proximal muscular weakness. Detection and stimulation-detection EMG demonstrated myogenic signs in at least two muscles in all patients. Myogenic signs were dominant in all proximal muscles. Latencies were normal in all patients. Motor nerve conduction velocities were slowed in three infants and in one adolescent. A temporal dispersion of motor responses was observed in 11 proximal muscles. The muscle biopsy, performed in five cases, revealed an inequality in the calibre of fibres, with atrophy dominating in type II fibres. The authors emphasize the value of EMG in disclosing the myopathic process, thereby contributing to the etiological diagnosis of motor difficulties in children suffering from malnutrition or a chronic disease.