Nonsurgical Neurological Emergencies in Children: A Cross-Sectional Study of Prevalence, Diagnosis, and Management

Abstract

Background: This study aimed to outline the spectrum of pediatric neurological emergencies, assess their prevalence, describe diagnostic approaches, and identify treatment strategies used in their management in a resource-limited country.

Methods: This was a cross-sectional study carried out from January 1, 2024, to June 30, 2024, in Garoua General Hospital, Garoua Regional Hospital Center, and Garoua Regional Hospital. Patients' files were collected from January 1, 2023, to April 30, 2024, hence a study period of 16 months. Analysis was done using Excel 2016, and P values < 0.05 were considered as statistically significant.

Results: Of all 3602 children hospitalized in pediatric departments, the prevalence of pediatric neurological emergencies was 6.7%. These emergencies were predominant in children aged between five and 10 years (40.62%) with a median age of 4 years. Males (52.68%) had more emergencies compared with females. Febrile convulsions were the most predominant (63.4%) with the main etiology being meningitis and severe malaria being the differential diagnosis (85.8%). Afebrile convulsions represented 20.1%, with epilepsy as the leading cause, occurring in 11.6% (n = 26). The most observed symptom was convulsions with 81.7% for generalized seizures and 4.5% for partial seizures; this was followed by fever (63.8%), vomiting (44.2%), and headache (29.9%). The majority of hospitalized patients were discharged (81.7%); 12.9% checked out against medical advice, and 5.4% died.

Conclusions: Neuropediatric emergencies are frequent and contribute to an increase in infant and child mortality rate. Early diagnosis will lead to early therapy and hence greater chances of survival.

Keywords: Management; Neurological prevalence; Outcome; Pediatric emergencies.