The Yield of Neuroimaging in Children Presenting to the Emergency Department With Acute Ataxia in the Post-Varicella Vaccine Era.

Abstract

To determine the yield of neuroimaging in children presenting to the emergency department with acute ataxia in the post-varicella vaccine era, we conducted a cross-sectional study between 1995 and 2013 at a single pediatric tertiary care center. We included children aged 1-18 years evaluated for acute ataxia of <7 days' duration. The main outcome was clinically urgent intracranial pathology defined as a radiologic finding that changed initial management. We identified 364 children, among whom neuroimaging was obtained in 284 (78%). Forty-two children had clinically urgent intracranial pathology (13%, 95% confidence interval 9%-17%); tumors and acute disseminated encephalomyelitis were the leading findings. Age ≤3 years and symptoms ≤3 days of duration were predictors of low risk (0.7%, 95% confidence interval 0%-4.4%). In conclusion, neuroimaging may be indicated for most patients presenting with acute ataxia. Neuroimaging may be deferred in younger children with short duration of symptoms contingent on close follow-up.

• Authors: Tiffany Rudloe, Sanjay P Prabhu, Mark P Gorman, Lise E Nigrovic, Marvin B Harper, Assaf Landschaft, Amir A Kimia
• Journal: Journal of child neurology (J Child Neurol) Vol. 30 Issue 10 Pg. 1333-9 (Sep 2015) ISSN: 1708-8283 [Electronic] United States
• PMID: 25535060 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2014.

Topics

• Acute Disease
• Adolescent
• Age Factors
• Ambulatory Care
• Ataxia (diagnosis, pathology, therapy)
• Brain (pathology)
• Child
• Child, Preschool
• Cross-Sectional Studies
• Emergency Service, Hospital
• Female
• Humans
• Infant
• Male
• Neuroimaging
• Risk
• Time Factors