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Acute paediatric paraplegia: A case series review

Lookup NU author(s): Dr Rob Forsyth

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Abstract

Paediatric paraplegia resulting from spinal cord pathology of any cause is rare; hence prognostic information for children less than 16 years is limited. This case series review aims to ascertain all cases of paediatric paraplegia from 1997 to 2012 in the former Northern Region of England. Methods: Children presenting with sudden paraplegia before the age of 16 years were multiply ascertained from databases in the regional paediatric neurology, neuroradiology, neuro-oncology and adult spinal injuries units. Data were obtained from retrospective case note review. Results: A total of 44 cases (24 female) were identified. The incidence is estimated at 0.49 per 100,000 children under 16/year (95% confidence interval 0.41-0.57). Mean age of onset was 8.8 years and the most common aetiology was inflammatory. Twelve months post presentation, mortality was zero and a good outcome (defined as Gross Motor Function Classification System grades I or II) was seen in 66.6%. Motor outcome at 12 months was associated with the presence of bladder/bowel signs at presentation, previous viral illness and initial severity of paraplegia. Bladder signs at presentation were the strongest predictor of prognosis (OR for poor motor outcome 10.3). We were unable to demonstrate a relationship between aetiology and late outcome. Conclusion: Paediatric paraplegia is rare. Mortality rates are low and 66.6% have a good outcome with fully or nearly independent walking. Bladder signs are the strongest predictor of prognosis. (C) 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.


Publication metadata

Author(s): Sharpe AN, Forsyth R

Publication type: Review

Publication status: Published

Journal: European Journal of Paediatric Neurology

Year: 2013

Volume: 17

Issue: 6

Pages: 620-624

Print publication date: 24/06/2013

ISSN (print): 1090-3798

ISSN (electronic): 1532-2130

Publisher: ELSEVIER SCI LTD

URL: http://dx.doi.org/10.1016/j.ejpn.2013.05.014

DOI: 10.1016/j.ejpn.2013.05.014


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