A review of attendances at Paediatric Accident and Emergency Department at Mater Dei Hospital for neurological complaints patient

Abstract

Aims: Attendances at paediatric accident and emergency department (A&E) during a six month period were reviewed to determine the proportion of children with neurological complaints, type of symptoms and the outcomes in terms of admissions, discharges and out-patient referrals. Methods: Neurological complaints were classified as (a) febrile convulsions, (b) unprovoked seizures, (c) status epilepticus, (d) headaches, (e) altered consciousness, (f) acute ataxia, (g) flaccid weakness, (h) visual loss, or (i) others. Outcomes of these attendances were also recorded as either admission, referrals to out-patient clinics or discharges from A&E. Results: A total of 7670 children attended paediatric A&E during the study time of which 352 (4.5%) presented with neurological complaints. 173 children (49%) presented with headache, 54 (15.3%) presented with unprovoked seizures, 51 (14.4%) presented with febrile convulsions, 34 (9.6%) presented with altered consciousness and the remaining 40 children (11.7%) presented with various other complaints. 24.8% of children who presented with headache were admitted, 34.1% were referred to out-patient clinics and 41% were discharged. In contrast, 75.5% of children you presented with unprovoked seizures were admitted, 22.2% were referred to out-patient clinics and 3.7% were discharged. There were no deaths. Conclusion: 1 in 20 children who attended paediatric A&E presented with neurological complaints. One half of these children presented with headache, around one third presented with seizures (febrile and unprovoked), around 10% presented with altered consciousness. Around a half of these children were admitted, a quarter were discharged home and the other quarter were referred to out-patient clinics.