Cerebral atrophy in protein energy malnutrition

ABSTRACT

CT scans of 60 patients with various forms and degrees of PEM were studied. The patients were classified clinically as suffering from marasmus, KWO or marasmic KWO. Anthropometric measurements based on expected weight, length, head circumference and arm circumference for age using Egyptian percentile curves were studied. Biochemical studies of serum total proteins, albumin, protein electrophoresis and electrolytes were also carried out. The degree of cortical and/or central atrophy was noted by measuring the bifrontal index [BFX], sylvian fissure [SF], interhemispheric fissure, cortical sulci and basal cisterns. BFX and SF measurements showed statistically significant higher values in the 3 groups compared to the control group except for BFX which was statistically not significant in cases of marasmus. Comparing the 3 groups together, it was found that the BFX was statistically and significantly higher in KWO than in marasmus indicating a more severe degree of central atrophy in KWO. A positive correlation was found between duration of the disease and the degree of both cortical and central atrophy. Follow up studies of some cases showed marked improvement of CT scan findings after treatment