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Spectrum of Common Paediatric Neurological Disorders: a cross-sectional study from three tertiary care centres across Pakistan

      Abstract

      Background

      There is dearth of information on spectrum of neurological disorders amongst children less than 18 years of age. The aim of this study is to identify the commonly presenting neurological disorders among children ≤ 18 years in Pakistan.

      Methods

      We conducted a cross-sectional study from August 2017 to December 2019 at three large tertiary care hospitals in Pakistan.

      Results

      A total of 17,176 children were included in our study, of which 61.8% were boys and 38.2% females. The most commonly presenting neurological disorder was epilepsy (36%). This was followed by behaviour disorders with 16% prevalence, then cerebral palsy (10.5%), headache disorder (3.6%), CNS sequelae (2.4%), developmental disorder (2.1%), movement disorder (1.7%), infectious causes (1.2%), vascular disease (0.7%), neuroinflammatory (0.6%), neurocutaneous disorders (0.6%), acute flaccid paralysis (0.6%) and cerebellar ataxia disorders (0.3%). Significant association was identified between children less than five years of age and greater prevalence of behavioural disorders (p<0.001), cerebral palsy (p<0.001), infections (p=0.014), sequalae (p<0.001) and developmental disorders (p<0.001). A significant difference was found between children greater than five years of age and children less than five years of age with higher prevalence of epilepsy (p<0.001), headache disorders (p<0.001), movement disorders (<0.001), neuroinflammatory diseases (p=0.005 and acute flaccid paralysis (p=0.014) in children greater than five years of age. Gender-wise distribution showed a significant difference with higher prevalence amongst females for epilepsy (p=0.009), headache disorders (p<0.001), neuroinflammatory disorders (p=0.025) and neurocutaneous syndromes (p<0.001), and a higher prevalence amongst males for behavioural diseases (p<0.001), cerebral palsy (p=0.009) and movement disorders (p<0.001) .

      Conclusion

      The results of this analysis helps to assess the commonly presenting neurological disorders in children less than and equal to 18 years of age. To the best of our knowledge, this study is the first of its kind and it helps healthcare workers in resource poor settings to be mindful of the common neurological disorders while diagnosing a child with neurological symptoms in an outpatient setting. Health care providers need to be trained to identify and treat these common conditions, however, there is still a dire need to assess the actual burden and hence more trained paediatric neurologists across the country.

      Key words

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