Magnetic Resonance Imaging Findings in Delayed Milestones Associated with Additional Clinical Features in Pediatric Patients

Authors

  • Rehana Magsi Liaquat University of Medical & Health Sciences, Jamshoro. Sindh. Pakistan.
  • Aurangzeb Kalhoro Liaquat University of Medical & Health Sciences,, Hyderabad https://orcid.org/0000-0002-6128-6984
  • Abdul Rauf Memon Liaquat University of Medical & Health Sciences, Jamshoro. Sindh. Pakistan.
  • Vashdev Khimani Liaquat University of Medical & Health Sciences, Jamshoro. Sindh. Pakistan.
  • Mahesh Kumar Luhano Liaquat university of Medical and Health Sciences Jamshoro, Sindh, Pakistan

DOI:

https://doi.org/10.36283/ziun-pjmd14-4/081

Keywords:

MRI brain, Clinical features, Developmental delay

Abstract

Background: Rare, but the delay in the process of achieving milestones has a devastating effect,
with a vast number of etiologies associated with it. This study aimed to identify the brain MRI
findings in patients showing additional clinical features with developmental delay and the
development of a correlation between clinical findings and MRI findings.
Methods: This cross-sectional study included 22 patients with developmental delay at Liaquat
University of Medical and Health Sciences, Hyderabad, from August 2022 to August 2024, using
non-probability consecutive sampling. Clinical histories, examinations, and brain MRIs using a
1.5 Tesla scanner were conducted. Data were analyzed in SPSS v26. Descriptive statistics, Chi-
square or Fisher’s exact test were applied, and a p-value <0.05 was considered statistically
significant for associations between clinical features and MRI findings.
Results: The study included 22 patients, evenly distributed between genders (11 males and 11
females). The majority, 10 (45.5%), were aged 2–5 years. The most common clinical
manifestations were epilepsy (14, 63.6%, p = 0.01), gait disturbance (13, 59.1%, p = 0.03), gross
developmental delay (9, 40.9%, p = 0.04), visual and auditory disturbances (7, 31.8%, p = 0.02),
motor disturbances (7, 31.8%, p = 0.05), neurological deficits (7, 31.8%, p = 0.04), and speech
deformities (6, 27.3%, p = 0.03). Some cases also had associated radiological abnormalities. A p-
value < 0.05 was considered statistically significant.
Conclusion: Patients of delayed milestones that are exposing additional clinical features are
likely to have some kind of abnormalities on MRI scan despite of their etiological variables.

Author Biographies

  • Rehana Magsi, Liaquat University of Medical & Health Sciences, Jamshoro. Sindh. Pakistan.

    Department of Neurosurgery

  • Aurangzeb Kalhoro, Liaquat University of Medical & Health Sciences,, Hyderabad

    Department of Neurosurgery

  • Abdul Rauf Memon, Liaquat University of Medical & Health Sciences, Jamshoro. Sindh. Pakistan.

    Department of Neurosurgery

  • Vashdev Khimani, Liaquat University of Medical & Health Sciences, Jamshoro. Sindh. Pakistan.

    Department of Neurosurgery

  • Mahesh Kumar Luhano, Liaquat university of Medical and Health Sciences Jamshoro, Sindh, Pakistan

    Department of Molecular Biology

References

1. Corn E, Andringa-Seed R, Williams ME, Arroyave-Wessel M, Tarud R, Vezina G, et al. Feasibility and success of a non-sedated brain MRI training protocol in 7-year-old children from rural and semi-rural Colombia. Pediatr Radiol. 2024 Aug;54(9):1513-22. doi: 10.1159/000506900.

2. Bhat R, Kashyap H, Kini P, Hebbar S. Characteristics of hearing impairment in children aged six months to two years with global developmental delay. J Nepal Paediatr Soc. 2021 Nov 3;41(2):140-6. doi: 10.3126/jnps.v41i2.33961.

3. Masri AT, Oweis L, Ali M, Hamamy H. Global developmental delay and intellectual disability in the era of genomics: Diagnosis and challenges in resource limited areas. Clin Neurol Neurosurg. 2023 Jul 1;230:107799. doi: 10.1016/j.clineuro.2023.107799.

4. Meng W, Zhang Q, Ma S, Cai M, Liu D, Liu Z, et al. A lightweight CNN and Transformer hybrid model for mental retardation screening among children from spontaneous speech. Comput Biol Med. 2022 Dec 1;151:106281. doi: 10.1016/j.compbiomed.2022.106281.

5. Banaru D, Boyd D, Halevy M, Oliver A, Orsat‐Parker K, Brien M, et al. Social capital of families of children with neurodevelopmental disabilities in South India. Dev Med Child Neurol. 2024 Dec;66(12):1632-43. doi: 10.1111/dmcn.15949.

6. Ali AS, Syed NP, Murthy GS, Nori M, Abkari A, Pooja BK, et al. Magnetic resonance imaging (MRI) evaluation of developmental delay in pediatric patients. J Clin Diagn Res. 2015 Jan 1;9(1):TC21. doi: 10.7860/JCDR/2015/11921.5478.

7. Kim S. Worldwide national intervention of developmental screening programs in infant and early childhood. Clin Exp Pediatr. 2021 Sep 30;65(1):10. doi: 10.3345/cep.2021.00248.

8. Almahmoud OH, Abushaikha L. Prevalence and risk factors of developmental disabilities among preschool children in the Arab world: a narrative literature review. Child Health Nurs Res. 2023 Apr 30;29(2):101. doi: 10.4094/chnr.2023.29.2.101.

9. Krishnarjun M, Rangankar VP, Zaman SU. Diffusion Tensor MR Imaging Evaluation in Children with Developmental Delay. Med J Dr DY Patil Univ. 2023 Oct 1;16(Suppl 2):S200-8. doi: 10.4103/mjdrdypu.mjdrdypu_100_22.

10. Claessens NH, Smits MJ, Benders MJ. Enhancing daily life for children with cognitive developmental delay through insights into brain development. Pediatr Res. 2024 Oct 18:1-0. doi: 10.1038/s41390-024-03616-3.

11. Tervo RC. Identifying patterns of developmental delays can help diagnose neurodevelopmental disorders. Clin Pediatr (Phila). 2006 Jul;45(6):509-17. doi: 10.1177/0009922806290566.

12. Garfinkle J, Shevell MI. Cerebral palsy, developmental delay, and epilepsy after neonatal seizures. Pediatr Neurol. 2011 Feb 1;44(2):88-96. doi: 10.1016/j.pediatrneurol.2010.09.001

13. Eisenmajer R, Prior M, Leekam S, Wing L, Ong B, Gould J, et al. Delayed language onset as a predictor of clinical symptoms in pervasive developmental disorders. J Autism Dev Disord. 1998 Dec;28:527-33. doi: 10.1023/A:1026004212375

14. Nicita F, Ginevrino M, Travaglini L, D'Arrigo S, Zorzi G, Borgatti R, et al. Heterozygous KIF1A variants underlie a wide spectrum of neurodevelopmental and neurodegenerative disorders. J Med Genet. 2021 Jul 1;58(7):475-83. doi: 10.1136/jmedgenet-2020-107007.

15. Stellingwerff MD, Al-Saady ML, Chan KS, Dvorak A, Marques JP, Kolind S, et al. Quantitative MRI distinguishes different leukodystrophies and correlates with clinical measures. Eur Radiol. 2024 Sep 25:1-3. doi: 10.1007/s00330-024-11089-5.

16. Yılmaz Y, Karademir M, Caygın T, Yağcıoğlu OK, Özüm Ü, Kuğu N. Executive functions, intellectual capacity, and psychiatric disorders in adults with type 1 Chiari malformation. World Neurosurg. 2022 Dec 1;168:e607-12. doi: 10.1016/j.wneu.2022.10.058.

17. Qurban Q, Kamil Z, Tebha SS, Zaidi ZA, Said M, Zehra SF, et al. Ocular manifestations in a patient with Dandy-Walker malformation: A case report. Radiol Case Rep. 2022 Mar 1;17(3):812-5. doi: 10.1016/j.radcr.2021.12.027.

18. Cayre M, Falque M, Mercier O, Magalon K, Durbec P. Myelin repair: from animal models to humans. Front Cell Neurosci. 2021 Apr 14;15:604865. doi: 10.3389/fncel.2021.604865.

19. Alshareef M, Tyler M, Litts C, Pearce J, Yazdani M, Eskandari R. Prevalence of visible subdural spaces in benign enlargement of subarachnoid spaces in infancy: a retrospective analysis utilizing magnetic resonance imaging. World Neurosurg. 2022 Aug 1;164:e973-9. doi: 10.1016/j.wneu.2022.05.079.

20. Spahiu L, Behluli E, Grajçevci-Uka V, Liehr T, Temaj G. Joubert syndrome: Molecular basis and treatment. J Mother Child. 2022 Mar 1;26(1):118-23. doi: 10.34763/jmotherandchild.20222601.d-22-00034.

21. Huntingford SL, Boyd SM, McIntyre SJ, Goldsmith SC, Hunt RW, Badawi N. Long-Term Outcomes Following Hypoxic Ischemic Encephalopathy. Clin Perinatol. 2024 Sep 1;51(3):683-709. doi: 10.1016/j.clp.2024.04.008,

22. Coryell J, Singh R, Ostendorf AP, Eisner M, Alexander A, Eschbach K, et al. Epilepsy surgery in children with genetic etiologies: A prospective evaluation of current practices and outcomes. Seizure. 2023 Dec 1;113:6-12. doi: 10.1016/j.seizure.2023.10.011.

23. Sass JO, Knerr I. Aspartoacylase Deficiency (Canavan Disease, N-Acetylaspartic Aciduria). In: Human Pathobiochemistry: From Clinical Studies to Molecular Mechanisms. Singapore: Springer Singapore; 2019 Mar 14. doi: 10.1007/978-981-13-2977-7_2.

24. Kalhoro AU, Rajper SB, Hashim AM. Meningomyelocele and Surgical Outcome of Meningomyelocele: Single Center Study. Pak Pediatr J. 2022 June;46(2):174-79.

25. Alamri A, Aljadhai YI, Alrashed A, Alfheed B, Abdelmoaty R, Alenazi S, Alhashim A, Benini R. Identifying clinical clues in children with global developmental delay/intellectual disability with abnormal brain magnetic resonance imaging (MRI). Journal of Child Neurology. 2021 May;36(6):432-9. doi.org/10.1177/0883073820977330

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Published

2025-09-29

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How to Cite

1.
Magsi R, Kalhoro A, Memon AR, Khimani V, Luhano MK. Magnetic Resonance Imaging Findings in Delayed Milestones Associated with Additional Clinical Features in Pediatric Patients. PJMD [Internet]. 2025 Sep. 29 [cited 2026 Jun. 17];14(4). Available from: https://ojs.zu.edu.pk/pjmd/article/view/3596

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