Yatan Hasta Çocuk Nörolojisi Konsültasyon Sonuçları

Yıl 2022, , 533 - 539, 19.07.2022

Arzu Ekici , Cengiz Havalı , Emre Baldan , Muharrem Bostancı , Nevin Kılıç

https://doi.org/10.20515/otd.1017060

Öz

Çocuk nörolojisi, çok çeşitli ilgili konuları kapsar. Bir çocuk yürüyememekten veya baş ağrısından şikayet ettiğinde hem doktorlar hem de ebeveynler endişelenir ve teşhisi ertelemekten korkarlar. Bu çalışmanın amacı, pediatrik nöroloji yatan hasta konsültasyonlarını değerlendirmekti. Pediatrik nöroloji yatan hasta konsültasyonları için toplam 1.669 talep, bir yıllık süre içinde geriye dönük olarak incelendi. Çocuk nörolojisi konsültasyonlarının en sık nedenleri nöbet ve ateşli nöbet (sırasıyla %60,6 ve %12.2) idi. Nöromotor gelişimsel gecikme (%5,7), senkop (%3,4), baş ağrısı (%2,6), mental durum değişikliği (%2,1), akut yürüyememe şikayeti (%1,8), fasiyal sinir felci (%1,4), ataksi (%1.2) ve monoparezi/hemiparezi (%1) çocuk nörolojisi konsültasyonlarının diğer nedenleri arasındaydı. Nöbet nedeniyle konsülte edilen 57 hastaya (%8,8) nöbet tanısı konulmadı. Mental durum değişikliğinin en sık nedeni meningoensefalit idi. Akut yürüyememe şikayeti olan hastaların 9'u (%47,4) viral miyozit olarak değerlendirildi. Akut nörolojik semptomları olan bir hastada altta yatan basit bir neden olabileceği gibi ciddi bir neden de olabilir.

Anahtar Kelimeler

Çocuk, konsültasyon, yatan hasta, nöroloji

Destekleyen Kurum

Yok

Proje Numarası

YOK

Outcomes of Inpatient Child Neurology Consultations

Öz

Child neurology covers a wide range of relevant topics. Both doctors and parents are concerned when a child complains of being unable to walk or having a headache, and they are afraid of postponing the diagnosis. The goal of this study was to assess pediatric neurology inpatient consults. A total of 1,669 requests for pediatric neurology inpatient consultations were reviewed retrospectively during a one-year period. Seizure and febrile seizure were the most common reasons for child neurology consultations (60,6% and 12.2%, respectively). Neuromotor developmental delay (5.7%), syncope (3.4%), headache (2.6%), altered mental status (2.1%), acute complaint of inability to walk (1.8%), facial nerve paralysis (1.4%), ataxia (1.2%), and monoparesis/hemiparesis (1.2%) were among the other reasons for child neurology consultations (1%). Fifty-seven patients (8.8%) who were consulted owing to a seizure were not diagnosed as having seizures. The most common cause of changed mental status was meningoencephalitis. Nine (47.4%) of the patients with acute inability to walk were evaluated as viral myositis. In a patient with acute neurological symptoms, there may be a simple underlying cause or a serious cause.

Anahtar Kelimeler

Child, concultation, inpatient, neurology

Proje Numarası

YOK

Kaynakça

• Referans1. Luat AF, Kamat D, Sivaswamy L. Paroxysmal nonepileptic events in infancy, childhood, and ado-lescence. Pediatr Ann. 2015;44(2):e18-23.
• Referans2. O’Sullivan SS, Spillane JE, McMahon EM, Sweeney BJ, Galvin RJ, McNamara B, Cassidy EM. Clinical characteristics and outcome of patients diagnosed with psychogenic non-epileptic seizures: a 5-year review. Epilepsy Behavior. 2007;11(1):77-84.
• Referans3. Bodde NM, Brooks JL, Baker GA, Boon PA, Hendriksen JG, Mulder OG, Aldenkamp AP. Psycho-genic non-epileptic seizures-definition, etiology, treatment and prognostic issues: a critical review. Sei-zure. 2009;18(8):543-553. Referans4. Benbadis SR. Differential diagnosis of epilepsy. Continuum Lifelong Learn. Neurol. 2007;13:48-70.
• Referans5. Chadwick D, Smith D. The misdiagnosis of epilepsy. Br Med J. 2002;4:95–96.
• Referans6. Smith D, Defalla BA, Chadwick DW. The misdiagnosis of epilepsy and the management of refractory epilepsy in a specialist clinic. Q J Med. 1999;92:5-23.
• Referans7. Friedman KG, Alexander ME. Chest pain and syncope in children: a practical approach to the diagnosis of cardiac disease. J Pediatr. 2013;163:896-901.e1-e3.
• Referans8. Anderson JB, Czosek RJ, Cnota J, Meganathan K, Knilans TK, Heaton PC. Pediatric syncope: Nati-onal Hospital Ambulatory Medical Care Survey results. J Emerg Med. 2012;43:575-583.
• Referans9. Kanjwal K, Calkins H. Syncope in children and adolescents. Cardiol Clin. 2015;33:397-409.
• Referans10. Josephson CB, Rahey S, Sadler RM. Neurocardiogenic syncope: frequency and consequences of its misdiagnosis as epilepsy. Can J Neurol Sci. 2007;34:221-224.
• Referans11. Kabbouche MA, Cleves C. Evaluation and management of children and adolescents presenting with an acute setting. Semin Pediatr Neurol. 2010;17:105-118.
• Referans12. Button K, Capraro A, Monuteaux M, Mannix R. Etiologies and Yield of Diagnostic Testing in Children Presenting to the Emergency Department with Altered Mental Status. J Pediatr. 2018;200:218-224.e2. 13. Jain S, Kolber MR. A stiff-legged gait: benign acute childhood myositis. CMAJ. 2009;181:711-713.
• Referans14. Chung A, Deimling M. Guillain-Barré Syndrome. Pediatr Rev. 2018;39(1):53-54.
• Referans15. Rabie M, Nevo Y. Childhood acute and chronic immune-mediated polyradiculoneuropathies. European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society. 2009;13(3):209-218.
• Referans16. Mall S, Buchholz U, Tibussek D, et al. A large outbreak of influenza B associated benign acute childhood myositis in Germany, 2007/2008. Pediatr Infect Dis J. 2011;30(8):e142-6.
• Referans17. Psillas G, Antoniades E, Ieridou F, Constantinidis J. Facial nerve palsy in children: A retrospective study of 124 cases. J Paediatr Child Health. 2019;55(3):299-304.
• Referans18. Pavone P, Praticò AD, Pavone V, Lubrano R, Falsaperla R, Rizzo R, Ruggieri M. Ataxia in children: early recognition and clinical evaluation. Ital J Jediatr 2017;43(1):6.
• Referans19. Thakkar K, Maricich SM, Alper G. Acute Ataxia in Childhood: 11-Year Experience at a Major Pediatric Neurology Referral Center. J Child Neurol. 2016;31(9):1156-1160.