The neuropediatrician and the pediatric neurological emergencies

Background: 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.

Objective: To know the real incidence of pediatric neurological emergencies.

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.