Climate change and neurological disorders in childhood: A scoping review

Climate change's impact on global health is increasingly recognized, with growing focus on its effects on the developing brain and on children with neurological disorders. This scoping review aims to update the evidence on climate change's effects on paediatric neurological disorders.

A PRISMA-ScR-based protocol guided a systematic search across major databases (PubMed, Scopus, WoS, ClinicalTrials.gov, WHO ICTRP). We included all study types published in English up to September 2025 examining the impact of any climate-change related factor in children (0-18 years) with neurological disorders. Data extraction included study design, population, exposure/intervention and outcome variables.

Out of 482 records, 17 studies met the inclusion criteria, involving over 340,000 children (54.6% male, in studies reporting sex distribution) across Asia, Africa, North America, and Europe. A total of 15 out of 17 studies were observational (OCEBM level 3-4). Epilepsy and seizures were the most frequently investigated conditions (8/17 studies). Extreme heat triggered immediate increases in hospitalisations, while cold exposure showed delayed but prolonged effects (up to 21 days). Temperature variability and air pollution further amplified seizure risk. Winter storms disrupted medication access which led to seizure worsening. Other studies (5/17 studies) linked meningitis and encephalitis incidence to high temperatures, humidity, and seasonal variability, particularly in low-resource settings. Sunlight and humidity were common migraine triggers, and cold-related illness was differentially co-diagnosed across behavioural health disorders groups. Prenatal and early childhood exposure to temperature extremes was associated with altered white matter development on MRI in one study. Across conditions, children in socioeconomically disadvantaged settings consistently emerged as the most vulnerable.

Current evidence suggests that climate change-related exposures, particularly extreme temperatures, temperature variability, and natural disasters, negatively affect paediatric neurological health directly (increased seizure risk, impaired myelination) and indirectly (disrupted treatment access, emotional stress). Neuroinfectious diseases were also strongly associated with climatic variability, disproportionately affecting children in low-income areas. However, findings remain fragmented, heterogeneous, and largely context-specific, underscoring the urgent need for multicentric studies with harmonised methodologies and stronger longitudinal designs to clarify causal pathways and guide preventive strategies.