Severe neurological impairment: a review of the definition

Area of Science:

• Neurology
• Pediatrics
• Medical Research

Background:

• Severe neurological impairment (SNI) is frequently used in medical literature but lacks a standardized definition.
• This ambiguity impedes research on healthcare needs, treatment, resource allocation, and patient outcomes for children with complex medical conditions.

Purpose of the Study:

• To review the literature and assess the consistency of SNI term usage.
• To contextualize SNI within other terms describing children with severe, complex medical needs.
• To identify key components for a potential consensus definition of SNI.

Main Methods:

• A systematic literature review was conducted.
• Forty-two articles were included for full-text analysis.
• Definitions of SNI within these articles were extracted and analyzed.

Main Results:

• Only 23 out of 42 reviewed articles provided a definition for SNI.
• Commonly included definitional components were motor impairment (80%), intellectual disability (70%), and communication difficulties (30%).
• Less frequently included aspects were dependence on others for decision-making, chronicity, and distinction between central and peripheral nervous system disorders.

Conclusions:

• There is significant variation in the definition and application of the term SNI across medical literature.
• A consensus-based definition of SNI is needed to facilitate future research and improve understanding of these complex pediatric conditions.
• Key elements for defining SNI should prioritize mobility, intellectual disability, communication, and care needs.