A study of soft neurological signs in children with malnutrition

OBJECTIVE: Malnutrition is a clinical entity that occurs as a result of inadequate nutrient and energy intake. Soft neurological signs are abnormal motor or sensory signs detected at the examination in the absence of a neurological disorder with a detectable origin. Our study aimed to evaluate the relationship between the degree of malnutrition and soft neurological signs in children with malnutrition. MATERIALS AND METHOD: This study enrolled 57 patients aged 8-17 years with malnutrition who presented to Adnan Menderes University, Faculty of Medicine, Pediatric Gastroenterology Clinic between 01.01.2020-01.04.2020 and 59 healthy subjects. Case report forms consisting of sociodemographic data, anthropometric measurements, and neurological examination findings were filled for all subjects. Each subject was applied to the 'Neurological Evaluation Scale' developed by Buchanan&Heinrichs. RESULTS: Patients with malnutrition had a poorer socioeconomic level, lower parental educational level, lower birth weight, a higher rate of living in crowded families, and a higher rate of inadequate intake of breast milk than the healthy control group (p=0.005, p=0.003, p=0.023, p=0.003, p=0.024, p=0.017, respectively). Patients with malnutrition had a higher rate of soft neurological signs (p<0.001). A weight Z score cut-off point of ≤-1.255 SDS (p<0.001) increased the risk of having soft neurological signs by 116.66 folds; a height Z score cut-off point of ≤-1.010 -SDS (p<0.001) increased the risk of having soft neurological signs by 64.8 folds, and a body mass index Z score cut-off point of ≤-1 SDS (p<0.001) increased the risk of having soft neurological signs by 62.66 folds. The best total 'Neurological Evaluation Scale' score cut-off point that discriminated against the healthy control group and the malnutrition group was ≥7.5. CONCLUSION: Our study indicates that malnutrition increases the risk of developing soft neurological signs and causes adverse neurological involvement, to which a low socioeconomic level indirectly contributes. Therefore, we believe that health policies should be developed and implemented to prevent malnutrition. Keywords: Malnutrition, Soft Neurological Signs, Child