Comments on: MRI-brain for microcephaly?

By: Allison

Allison — Thu, 15 May 2008 16:26:42 +0000

If I were answering the question from the standpoint of someone who has personally worked with the boy in the picture in Ghana, I’d have to say no to the MRI for the same reasons as vijayashankara. Whilst in the first world, it’s a simple thing to get an MRI, in Hohoe, where Kokuvi lives, the closest MRI machine is either in Ho (1.5 hours) or Kumasi (~3 hours). Considering that the school doesn’t have transportation and that Kokuvi can’t easily be transported on public transportation, it makes absolutely no sense at all to take him in for an MRI. From his file, I can tell you that he’s never had a physical of any sort, but according to other employees at the school, his vision is impaired. He also has absolutely no attention span and the extent of his English is the word ‘chalk’. He doesn’t do much better in Ewe.

Considering the extent of his microcephaly, I’d have to say that supportive therapy is better than delving in and trying any other recourse. Again, it may be different in America, but in Ghana, that’s the best we can really do.

By: bphillips

bphillips — Wed, 14 May 2008 07:53:47 +0000

Allison - Thanks for the information! Clearly, all the images we use here in the site are illustrative, rather than representative.

By: Allison

Allison — Thu, 08 May 2008 14:25:23 +0000

Actually, Kokuvi (pictured) is 16.

By: iwacogne

iwacogne — Wed, 26 Mar 2008 14:09:49 +0000

OK, but there you have a different sort of argument.
There is the cost/benefit question, and the question of whether this sort of investigation does have a yield which might have a benefit.

I recognise that my view is developed-world centric, and I do, in my practice, have to consider cost/benefit for something like an MRI on the basis that it is a limited resource which I could quite easily mess up by over requesting. But it’s not the same question.

The question is: does this test have the possiblity to change your managment, and if so, how frequently will performing this test do that, and by how much?

By: vijayashankara

vijayashankara — Tue, 25 Mar 2008 16:58:47 +0000

I doubt the MRI would give a substantial information for family counselling; the cost of MRI scan, particularly in a developing country, will outweigh the benefits.

By: Ian Wacogne

Ian Wacogne — Tue, 25 Mar 2008 16:23:26 +0000

Well…

The MRI might tell you important autosomal recessive/autosomal dominant information. Which might give you information which will allow you give the family clear advice about future family.

I doubt very much if the scan will tell you much about the future for the child, but it might have important consequences for his family.

By: vijayashankara

vijayashankara — Mon, 24 Mar 2008 12:45:28 +0000

No, I would not do a MRI scan, Instead I would do a IQ testing and plan how I can help the boy