Characteristics of Acute Nystagmus in the Pediatric Emergency Department
- 1 August 2020
- journal article
- research article
- Published by American Academy of Pediatrics (AAP) in PEDIATRICS
- Vol. 146 (2)
- https://doi.org/10.1542/peds.2020-0484
Abstract
OBJECTIVES: Acute nystagmus (AN) is an uncommon neurologic sign in children presenting to pediatric emergency departments. We described the epidemiology, clinical features, and underlying causes of AN in a large cohort of children, aiming at identifying features associated with higher risk of severe underlying urgent conditions (UCs). METHODS: Clinical records of all patients aged 0 to 18 years presenting for AN to the pediatric emergency departments of 9 Italian hospitals in an 8-year period were retrospectively reviewed. Clinical and demographic features and the underlying causes were analyzed. A logistic regression model was applied to detect predictive variables associated with a higher risk of UCs. RESULTS: A total of 206 patients with AN were included (male-to-female ratio: 1.01; mean age: 8 years 11 months). The most frequently associated symptoms were headache (43.2%) and vertigo (42.2%). Ataxia (17.5%) and strabismus (13.1%) were the most common neurologic signs. Migraine (25.7%) and vestibular disorders (14.1%) were the most common causes of AN. Idiopathic infantile nystagmus was the most common cause in infants CONCLUSIONS: AN should be considered an alarming finding in children given the risk of severe UCs. Cranial nerve palsy, ataxia, and strabismus should be considered red flags during the assessment of a child with AN.This publication has 24 references indexed in Scilit:
- Stroke and nonstroke brain attacks in childrenNeurology, 2014
- Nystagmus-Based Approach to Vertebrobasilar Stroke Presenting as Vertigo without Initial Neurologic SignsEuropean Neurology, 2013
- Brainstem Strokes in Children: An 11-Year Series From a Tertiary Pediatric CenterPediatric Neurology, 2013
- Basilar artery strokes in children: good outcomes with conservative medical treatmentDevelopmental Medicine and Child Neurology, 2013
- Infantile and acquired nystagmus in childhoodEuropean Journal of Paediatric Neurology, 2012
- Dizziness in the Emergency Room: Diagnoses and MisdiagnosesEuropean Neurology, 2011
- Brain Tumor Signs and Symptoms: Analysis of Primary Health Care Records From the UKCCSPEDIATRICS, 2010
- Spectrum of Dizziness Visits to US Emergency Departments: Cross-Sectional Analysis From a Nationally Representative SampleMayo Clinic Proceedings, 2008
- Stroke Among Patients With Dizziness, Vertigo, and Imbalance in the Emergency DepartmentStroke, 2006
- Posterior circulation stroke in childhoodNeurology, 2002