Clinical Analysis of the Pediatric Patients with Neurological Disorders Seen in the Emergency Department

Park, Seung Wan; Chae, Soo Ahn; Lee, Jae Hee; Lee, Jung Ju; Yoon, Shin Won; Lim, In Seok; Choi, Eung Sang; Yoo, Byoung Hoon

Abstract

PURPOSE
Pediatric emergencies with seizure and decreased mental status or loss of consciouseness may cause severe complications without early proper management. Distribution of neurological disorders may differ according to various demographics, it would be valuable to evaluate recent data in Korea.
METHODS
Patients who had neurological problems and below 18 years old were defined as case. 1,058(5.6%) cases who visited the emergency department of Chung-Ang University Hospital from January 2005 to December 2008 were analyzed. The patients were also divided into four age groups: age 1 year or younger, preschool children(2-5 years), middle childhood group(6-10 years), and adolescent group(11-18 years).
RESULTS
The male to female ratio was 1.5:1. Most children were between 2 to 5 years old(mean age=3 years). Febrile convulsion is the most common neurological disorders among infant and preschooler, meningitis is the most common among middle childhood, epilepsy and headache is the most common among adolescent. Main initial presentations were seizure followed by fever, headache and vomiting. Febrile convulsion was the most common neurological disorders followed by epilepsy and meningitis. Final dispositions of patients were admission, discharge, against medical device, and transfer to other hospital. Admission rate of patients with neurological disorders was higher than those of total patients.
CONCLUSION
Neurological disorders are increasing in pediatric emergencies and have highest admission rate, mostly because of the parent's anxiety and severity of disease itself. Therefore, not only detect and treat neurological disorder in early stage, but also reassuring parent is important.