Abstract

Dr. Shaoli Sarker, Dr. A. Z. M. Azam

ABSTRACT

Background: An inter-department referral system is indeed a modern approach to rehabilitation for interdisciplinary and multidisciplinary patient management of chronic and complex cases. Several departments might have child patients who need certain specialist care on neurological disorders who are referred by specialists of other disciplines to the pediatrics neurology department for specified diagnosis & proper management since they excel in such cases. Objective: In this study, our main goal is to evaluate the inter-departmental referral pattern for children with neurological complaints in a Tertiary Care Children’s Hospital. Methods: This retrospective study was done over a period from May 2021 to October 2021. Where 1070 children with neurological problems who attended the specialized care unit referral visits were included as a sample size. The data recorded in a register included the following; patients’ age, sex, past medical history with an emphasis on the history of pregnancy and delivery, a general clinical evaluation, thorough neurological evaluation. The data also included the provisional diagnosis, the treatment given, and the advice and the referral information. Results: During the study, the majority belonged to 1month to 12 months, 29.90%. Followed by 22.90% belonging to 7 to 10 years, 16.73% belonging to 1 to 2 years, 14.20% belonging to 0-28 days, and 12.05% belonging to 3 to 6 years. 69.81% were male, and where the majority were coming from rural, 63.08%. Most had Epilepsy 24.3%, followed by Cerebral palsy with comorbidity in 19.16%, Meningoencephalitis with complications in 17.29%, Neonates with seizures in 11.77%,25% of children admitted to PICU, NICU, and CCND. The reason for referral were intractable seizures, acute stroke, and metabolic derangements. Most patients at the Adolescent unit are visited with complaints of epilepsy with poor seizure control, somatic symptom disorder, and malingering. 10% received mechanical ventilation. Conclusion: This study showed the number of children that are getting admitted with neurological and neurodevelopmental disorders in a tertiary care children’s hospital is significant, where epilepsy cases were most common. The interdisciplinary referral system plays an important role in the appropriate holistic management and opens up the opportunity for further follow-up at the pediatrics neuroscience department which further results in better compliance and outcome.