The Yield of Neuroimaging in Children Presenting to the Emergency Department With Acute Ataxia in the Post–Varicella Vaccine Era. (September 2015)

• Record Type: Journal Article
• Authors: Rudloe, Tiffany; Prabhu, Sanjay P.; Gorman, Mark P.; Nigrovic, Lise E.; Harper, Marvin B.; Landschaft, Assaf; Kimia, Amir A.
• Is Part Of: Journal of child neurology. Volume 30:Number 10(2015:Sep.)
• Page Start: 1333
• Page End: 1339
• Publication Date: 2015-09
• Subjects: ataxia -- imaging -- emergency department; Nervous system -- Diseases -- Periodicals; 618.928
• DOI: 10.1177/0883073814561300
• Languages: English
• ISSNs: 0883-0738

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.