NEUROLOGICAL DISORDERS WHO FOLLOW UP IN PEDIATRIC NEUROLOGY CLINIC IN AIN SHAMS UNIVERSITY

Abstract

Good nutrition is the cornerstone of health and well-being for children with neurological disorders, although interpretation of nutritional adequacy difficult in these children. Our scope was to assess the nutritional status of children with neurological disorders. This study was conducted in Ain Shams University Hospitals, Pediatric Neurology Clinic, on 302 children aged from 6 months to >12 years who were comprised in 2 groups as follows: Group 1 (cases): One hundred fifty one children with neurological disorders recruited from the Pediatric Neurology Clinic. The patient divided into 4 sub groups according to their neurological disorders: • Sub group (A) :- 27 children with motor deficit (17.88%)(e.g.DMD, SMA, Myopathy, Ataxia, MG, Flobby infant, Hemplegia, post encephalitic sequalae). • Sub group(B) :- 28 children with mental deficit (18.54%)(e.g.learning disability, Speech delay, MR, Autism). • Sub group( C):- 72 children with combined motor &mental deficit (47.68%)(e.g. CP, Post encephalitic, Hydrocephalus, Mitochondrial disorder, Tay Sach $, Tubular sclerosis, Leucodystrophy, GDD, Psychomotor regression). • Sub group (D):- 24 children with epilepsy without motor and mental deficit (15.89%). Group 2 (control group): One hundred fifty one apparently normal children, they were recruited from the children attending the Outpatients' Clinic. Both patients and controls were further subdivided into four subgroups according to their ages and their dietary intake:  Subgroup (I) from 6 months -2 years.  Subgroup (II) from 2-6 years.  Subgroup (III) from 6-12 years.  Subgroup (IV)> 12 years. The results of our study revealed: • Patients had significantly higherpercentage of bottle feeding, delaying in time of complementary feeding, food allergy, baby food (as a food texture) and grand parents (as a care giver) in comparison with controls. • Regarding patient groups, there were higher percentages of delaying in time of complementary feeding and baby food (as a food texture) in motor & mental group in comparison with other patient groups. • Patients had highly significant delay in the age of starting finger feeding, spoon feeding and feeding themselves in comparison with controls. • There was longer feeding duration among patients compared to controls and the longest duration was observed in motor & mental deficit group compared to other patient groups. • Higher percentage of feeding problems like (gagging, chocking, vomiting) in patients compared to controls, and the highest percentage was obsereved among motor & mental deficit group compared to other patient groups. • Lower frequency of bowel habits were observed among patients compared to controls and the highest percentages were observed in motor & mental deficit group compared to other patient groups. • Patients had significantly lower values of z score in weight, height, BMI, mid arm circumference and head cicumference in comparison to the control, while in patient groups the highest z score values were observed in epilepsy deficit group and the lowest values were observed in motor & mental deficit group in comparison with other patient groups. • Patients had significant lower values of dietary Kcal,Protein,fiber,K,Ca,Mg,V.B1 and V.B2 compared to controls aged from(6m-2years) andlower values ofRDA of Mg,Iron,sel,Vitamin.B1 and Vitamin B2 in patients compared to controls in the same age range. • In age range (2-6 years) Patients had significant lower values of dietary Fiber, CHO, Na, P, Mg, Iron, Zn, Cu, Cholesterol and V.B1 compared to controls, and lower values of RDA in Kcal,Protein, Fiber, CHO, Na, P, Iron, Zn, Cu and vitamin B1 in patients compared to controls • In age range (6-12 years) there were significant lower values of dietary Fiber, CHO, Na, P, Iron, Zn, Cu and V.B1 are found inpatients compared to controls and lower values ofRDAin Kcal, protein,Fiber, CHO, Na, P, Mg, Iron, Zn, Cu and Vitamin B1 in patients compared to controls. • There was no significant difference between patients and controls (aged>12years) regarding calculated dietary intake and their RDA.