For children born with multiple congenital melanocytic nevi, a single MRI of the central nervous system within the first year of life was an effective way to screen for future outcomes, according to Dr. Regula Waelchli of Great Ormond Street Hospital for Children, London, and her associates.
Of the 271 children screened, 21% had an abnormal CNS MRI. An abnormal MRI increased the odds of negative future outcomes significantly. The most likely outcome was requirement for neurosurgery with an odds ratio of 71, followed by seizure with an OR of 13.4, and neurodevelopmental problems with an OR of 3.
The most common abnormality was intraparenchymal melanosis, present in most of the children with abnormal MRIs. However, if the only abnormality present was intraparenchymal melanosis, as it was for more than half of the abnormal group, no routine follow-up MRI was necessary and neurosurgery wasn’t required.
In patients with normal MRIs, seizures were temporary and/or easy to control with a single medication, and neurodevelopmental issues were mild, the investigators found.
While only those patients with an abnormality other than intraparenchymal melanosis require repeat MRIs, “any change in neurological status at any age should always trigger a repeat MRI, independent of the initial MRI findings,” Dr. Waelchli and her associates concluded.
Find the full study in the British Journal of Dermatology (doi: 10.1111/bjd.13898).