Magnetic Resonance Imaging, Developmental Delay, Hypoxic Ischemic Encephalopathy, Neonatal Hypoglycaemia
BACKGROUND Developmental disorders mean the lack of ability in children, to acquire various motor and cognitive milestones at expected maturational age. Neuroimaging, especially brain MRI, has proved to be one of the most reliable methods for evaluating developmentally delayed children, by providing information regarding brain tissue structures and anomalies. METHODS In this cross-sectional observational study, MRI features and clinical data of 60 children aged between 6 months to 12 years, who had been diagnosed with developmental delay using Denver developmental screening test were carefully evaluated and statistically analysed. Clinically diagnosed cases of cerebral palsy, neurodegenerative diseases, and syndromes were excluded. Ethical permission and written informed parental consent were obtained. RESULTS A total 60 children including 32(53.3%) male children and 28(46.7%) female children were studied. Out of them 45 children (75%) had abnormal magnetic resonance imaging findings-20(62.5%) male and 25(89.9%) female children. Abnormal brain magnetic resonance imaging findings included changes of hypoxic ischemic encephalopathy (60%), nonspecific findings (8.33%) and cerebral malformations (6.67%) No case due to metabolic cause was identified. Out of a total of 60 cases, 26.6% of children were born preterm and among the preterm babies, 93.7% had abnormal magnetic resonance imaging findings. In this study group, 24 patients (40%) had neonatal hypoglycaemia and out of them 23, (95.83%) had abnormal MRI findings. CONCLUSIONS This study showed that 75% of children without any clinically obvious cause for developmental delay, had abnormal MRI findings. The most common abnormality observed was hypoxic ischemic encephalopathy (HIE). Predisposing factors like birth asphyxia, neonatal hypoglycaemia, preterm delivery and low birth weight had significant correlation with abnormal MRI findings. Hence, MRI can be a useful tool in the diagnosis, management, and also for evaluation of prognosis in children without any evident cause for the developmental delay.
