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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[The neuropediatrician and the pediatric neurological emergencies]
J J García-Peñas1, R Muñoz-Orduña
1Sección de Neurología Pediátrica, Hospital Infantil Universitario Niño Jesús, Madrid, España. jgarciape.hnjs@salud.madrid.org
Insights
Pediatric neurological emergencies, including acute paroxysmal episodes and headaches, are common in emergency departments. Understanding these frequencies helps improve care for these critical pediatric conditions.
Area of Science:
- Pediatric Neurology
- Emergency Medicine
- Clinical Epidemiology
Context:
- Neurological emergencies represent a significant proportion of pediatric emergency department visits.
- Optimizing care requires understanding the spectrum and frequency of these conditions.
- This study analyzes one year of data from a pediatric tertiary hospital.
Purpose:
- To determine the actual incidence of pediatric neurological emergencies.
- To identify the most common causes and diagnoses of pediatric neurological emergencies.
- To inform the development of targeted clinical guidelines.
Summary:
- Neurological conditions accounted for 1,760 of 93,469 emergency visits (1.9%).
- Common presentations included acute paroxysmal episodes (48%) and headaches (41%).
- Headache (39%), non-epileptic paroxysmal episodes (20%), and epileptic seizures (15%) were leading diagnoses. Only 17% required admission, primarily for epilepsy (41%).
Impact:
- Neurological emergencies constitute a substantial portion of pediatric emergency care.
- Four conditions—headaches, non-epileptic paroxysmal episodes, epileptic seizures, and febrile convulsions—account for nearly 85% of neurological emergencies.
- Guidelines for pediatric neurological emergencies should focus on these prevalent conditions.
Introduction:
Knowledge of the spectrum and frequencies of pediatric neurological emergencies presenting to an emergency department is vital in optimizing the quality of care delivered locally.
Aim:
To know the real incidence of pediatric neurological emergencies.
Patients And Methods:
We present an observational study of a cohort of histories of neurological emergencies at a pediatric tertiary hospital during a period of one year.
Results:
On analysis of all emergencies (93,469 cases), 1,760 were neurological conditions. The commonest causes of consultation were acute paroxysmal episodes (48%), headache (41%) and gait disturbances (5%). Headache was the most often made diagnoses (39%), followed by acute non-epileptic paroxysmal episodes (20%) and e pileptic seizures (15%). Only 17% of patients needed hospital admission, being epilepsy the most frequent diagnoses involved (41%). The most common reasons for attending the pediatric emergency department are gastrointestinal and respiratory illnesses, neurological emergencies, and neonatal problems. Four illnesses, i.e. headaches, acute non-epileptic paroxysmal episodes, epileptic seizures and febrile convulsions, comprise nearly 85% of all the emergency visits of neurological origin.
Conclusions:
Neurological emergencies constitute a large percentage of pediatric emergencies. Guidelines developed for neurological emergencies should target the commonest presenting problem categories.
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