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在青少年中未被识别的焦点非运动性发作,向急诊室呈现

Nora Jandhyala¹, Monica Ferrer¹, Jacob Pellinen¹

¹From the Department of Neurology (N.J.), NYU Langone Health, New York; Departments of Pediatrics and Neurology (M.F.) and Neurology (H.T.G., J.F.), NYU Grossman School of Medicine, New York, NY; Departments of Neurology (J.P.) and Pediatrics and Neurology (K.L.P.), University of Colorado School of Medicine, Aurora; Department of Neurology (D.J.D.), Children's' Hospital of Philadelphia, PA; and Department of Neurology (L.L.T.), Washington University in St. Louis, MO.

|May 1, 2024

概括

急诊室经常错过青少年的非运动性发作,延迟了的诊断和治疗. 更好地识别这些微妙的发作对于在年轻患者的及时护理至关重要.

科学领域:

神经学神经学
儿科症儿科症
紧急医疗紧急医疗

背景情况:

患有未诊断的焦点的青少年经常寻求急诊室 (ED) 护理.
准确的发作史对于及时诊断和治疗至关重要.
这项研究检查了ED识别运动与非运动发作在青少年.

研究的目的:

调查急诊室 (ED) 对青少年运动与非运动的识别.
评估发作类型识别对青少年焦点的管理和治疗的影响.
为了识别患有非运动性发作的青少年的护理缺口,向ED提出.

主要方法:

对人类项目 (HEP) (2012-2017) 数据的回顾性分析.
纳入标准:12岁或以上,神经类型,在发作焦点治疗开始后4个月内.
从HEP招生医疗记录对初始诊断和管理的审查.

主要成果:

分析了83名青少年 (12-18岁);70%的人在被诊断为之前接受了ED.
运动性是最常见的ED表现 (90%),但38%的人有非运动性的病史.
非运动性发作不太可能被识别 (33%对81%) 并与较低的ED呈现率相关 (59%对82%).
在患有运动性的青少年中,没有非运动性的病史,这影响了治疗开始和入院率.
非运动性发作的诊断差距在青少年中比成年人更为明显.

结论:

非运动性发作在青少年中经常未被诊断出来,通常只有在演变为运动性发作后才被发现.
对于患有非运动性的青少年来说,存在很大的治疗差距,因EDS的认知不足而加剧.
医生必须积极询问非运动性发作症状,即使运动性发作是提出投诉的情况.
改善ED中非运动性发作识别对于患有的青少年至关重要.

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