Neuropsychological Changes in Children with Sickle Cell Disease and Their Correlation to the Imaging Studies
Marwa Yassien *
Department of Neurology, Faculty of Medicine, Tanta University, Egypt.
Hazem Fayed
Department of Neuropsychiatry, Faculty of Medicine, Tanta University, Egypt.
Mohamed El- Shanshory
Department of Pediatrics, Faculty of Medicine, Tanta University, Egypt.
Hassan Nassar
Department of Neuropsychiatry, Faculty of Medicine, Tanta University, Egypt.
Mohamed Osman
Department of Neuropsychiatry, Faculty of Medicine, Tanta University, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Early detection of neuropsychological changes in children with sickle cell disease (SCD) is essential to improve their quality of life.
Aim of the Work: To assess neurological and psychological disorders in children with sickle cell disease (SCD) using multimodal approach through clinical, laboratory, neuroimaging and neurophysiological studies in a trial to detect etiological risk factors.
Study Design: Cross-sectional study.
Place and Duration of Study: Sample: Department of Pediatric (Hematology Unit) and Department of Neurology, Tanta University Hospital Egypt, between April 2016 and April 2018.
Methodology: This study was conducted on 50 children (27 male and 23 female; age range 2-18 years) with SCD and 25 healthy children matched age and sex. All subjects were subjected to full history taking, neurologic examination using pediatric neurological sheet, laboratory investigations, neuroimaging including: CT and /or MRI, MRA and/or CT angiography, also MR, EEG and Stanford-Binet Intelligence scales-Fifth Edition.
Results: Most of patients presented with headache 66%, cognitive decline 48%, seizures 28%, and visual affection 24%. Less common presentations were, ischemic and hemorrhagic stroke 6% and 4% respectively. SCD children showed many abnormalities on neurological examination and on different modalities of MR imaging on the brain with positive correlation (X2=7.641, p-value <0.001*, r=0.248) with many risk factors. Prophylactic blood transfusion in SCD patients with abnormal TCD had a role in reducing the incidence of stroke.
Conclusion: Children with SCD were presented with variable neuropsychological disturbance that correlated with the brain imaging.
Keywords: SCD, neuropsychological, imaging