[The effects of protein-energy malnutrition on the central nervous system in children].

INTRODUCTION: Protein-energy malnutrition continues to affect millions of human beings in developing countries. Children suffer most from the shortage of nutrients because at early ages malnutrition has an important impact on the central nervous system. The changes that malnutrition triggers in the brains of these children will have severe consequences on their development and learning abilities.

DEVELOPMENT: Reports of important alterations in the head circumference and brain growth of malnourished children have been published in the literature, together with accounts of changes in both the dendritic arborisation and the morphology of the dendritic spines, as well as in myelination. Computerised tomography brain scans and magnetic resonance imaging in children suffering from malnutrition show images that are compatible with cerebral atrophy. The lack of environmental stimulation associated with malnutrition worsens the damage to the central nervous system. All the alterations that are observed in such cases give rise to important compromise of the child's higher brain functions, which may well lead to permanent neuropsychological damage.

CONCLUSIONS: Protein-energy malnutrition produces notable morphological changes in the brains of children in the developing world. These changes damage the intellectual potential of those who survive and limit their capacity to become part of the competitive world. Paediatric neurologists working in these areas of the world must make greater efforts to disseminate this problem and to make public institutions aware of the issue so that they do not desist in the fight against child malnutrition.