SPECTRUM OF NEUROLOGICAL ILLNESSES IN PEDIATRIC WARD OF NORTHWEST GENERAL HOSPITAL, PESHAWAR

ABSTRACT
Background: Neurological disorders affect a large percentage of population worldwide, both in low-income and
high-income countries. It also has socio-economic consequences and the treatment is comparatively more expensive
than other diseases in pediatric age group.
Objective: To find out the spectrum and burden of neurological illnesses and its associated mortality in pediatric ward.
Methods: A retrospective cross-sectional study was done on the medical records of children with primary diagnosis
of acute neurological illness in pediatric ward and intensive care unit from patient age 1 month to 16 years in a time
frame from January 2014 to June 2015 in Northwest General Hospital, Peshawar. Basic demographic data, primary
diagnosis, investigations performed, Glasgow coma scale and outcomes were documented on a structured datasheet.
Descriptive analysis was carried out.
Results: Over a span of 18 months 1150 patients were admitted in Pediatric ward out of which 135(11.7%) were diagnosed
with neurological illnesses with mean age of 45.7±44.5 months. Out of 135 diagnosed cases 80.7% (n=109)
had neurological diagnosis and 19.3% (n=26) had neurosurgical diagnosis. Patient with neurological diagnosis 71.9%
(n=97) were Non-traumatic cases and 8.9% (n=12) were neuromuscular disorders. In cases of Non-traumatic, 60.7%
(n=82) were structural cases in which majority of patients were diagnosed with infectious illnesses 47.7% (n=64).
Metabolic group of NTC had 11.1 % (n=15) cases with ischemic encephalopathy, 5.9%(n=8), being the most common
diagnosis. In neuromuscular illnesses, GBS were 6.7% (n=9) and myasthenia gravis cases were 2.2% (n=3). In all
neurological illnesses most common primary diagnoses were meningitis (18.5%), encephalitis (11.1%) and seizure
disorders (7.4%). In majority of the patients neuro-radiological tests were performed, CT scan was done on 65.9%
(n=89) and MRI on 52.6% (n=71), LP was performed on 38.5% (n=52) and EEG on 14.1% (n=19) of cases. . Mean
age of patients who died was 41.4± 32.5 months. Mortality in PICU of patients with neurological diagnosis was 32.7%.
Mortality rate in Pediatric ward was 12.6% (n=17) in which 35.3% (n=6) died of vascular causes.
Conclusion: Overwhelming amount of patients from Afghanistan was admitted with acute neurological illnesses. Infections
were the most common presentation in pediatric ward with Stroke most common cause of death. A very high
mortality rate was associated with patients admitted in PICU.
Key Words: Neurological illness, Non-traumatic cases, Neuromuscular disorders, Metabolic disorders, Neuro-radiological