Abstract
| Original language | English |
|---|---|
| Pages (from-to) | 722-729 |
| Number of pages | 8 |
| Journal | European Journal of Paediatric Neurology |
| Volume | 21 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2017 |
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Keywords
- Child
- Diplopia
- Double vision
- Emergency
- Life threatening condition
- Neuroimaging
- acute disease
- Article
- child
- clinical feature
- cohort analysis
- computer assisted tomography
- consultation
- controlled study
- diplopia
- emergency health service
- eye disease
- female
- human
- length of stay
- major clinical study
- male
- neuroimaging
- neurologic disease
- nuclear magnetic resonance imaging
- priority journal
- ptosis
- retrospective study
- school child
- strabismus
- visual disorder
- vomiting
- adolescent
- age
- clinical trial
- hospital emergency service
- hospitalization
- Italy
- multicenter study
- preschool child
- Acute Disease
- Adolescent
- Age Factors
- Child, Preschool
- Cohort Studies
- Emergency Service, Hospital
- Female
- Hospitalization
- Humans
- Male
Cite this
Acute diplopia in the pediatric Emergency Department. A cohort multicenter Italian study. / Raucci, U.; Parisi, P.; Vanacore, N.; La Penna, F.; Ferro, V.; Calistri, L.; Bondone, C.; Midulla, F.; Suppiej, A.; Falsaperla, R.; Cordelli, D.M.; Palmieri, A.; Verrotti, A.; Becciani, S.; Aguzzi, S.; Mastrangelo, M.; Pelizza, F.; Greco, F.; Carbonari, G.; Tallone, R.; Bottone, G.; Trenta, I.; Masi, S.; Villa, M.P.; Reale, A.
In: European Journal of Paediatric Neurology, Vol. 21, No. 5, 2017, p. 722-729.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Acute diplopia in the pediatric Emergency Department. A cohort multicenter Italian study
AU - Raucci, U.
AU - Parisi, P.
AU - Vanacore, N.
AU - La Penna, F.
AU - Ferro, V.
AU - Calistri, L.
AU - Bondone, C.
AU - Midulla, F.
AU - Suppiej, A.
AU - Falsaperla, R.
AU - Cordelli, D.M.
AU - Palmieri, A.
AU - Verrotti, A.
AU - Becciani, S.
AU - Aguzzi, S.
AU - Mastrangelo, M.
AU - Pelizza, F.
AU - Greco, F.
AU - Carbonari, G.
AU - Tallone, R.
AU - Bottone, G.
AU - Trenta, I.
AU - Masi, S.
AU - Villa, M.P.
AU - Reale, A.
N1 - Export Date: 11 April 2018 CODEN: EJPNF Correspondence Address: Raucci, U.; Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCSItaly; email: umberto.raucci@opbg.net References: Richardson, L.D., Joyce, D.M., Diplopia in emergency department (1997) Emerg Med Clin North Am, 15, pp. 649-664; Nazerian, P., Vanni, S., Tarocchi, C., Causes of diplopia in the emergency department: diagnostic accuracy of clinical assessment and of head computed tomography (2014) Eur J Emerg Med, 2, pp. 118-124; Alves, M., Miranda, A., Narciso, M.R., Mieiro, L., Fonseca, T., Diplopia: a diagnostic challenge with common and rare etiologies (2015) Am J Case Rep, 16, pp. 220-223; Friedmann, D.I., Pearls: diplopia (2010) Semin Neurol, 30, pp. 54-65; O'Colmain, U., Gilmour, C., MacEwen, C.J., Acute-onset diplopia (2014) Acta Ophtalmol, 92, pp. 382-386; Boutis, K., Cogollo, W., Fisher, J., Parental knowledge of potential cancer risk from exposure to computed tomography (2013) Pediatrics, 132, pp. 305-311; Miglioretti, D.L., Johnson, E., Williams, A., The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk (2013) JAMA Pediatr, 167, pp. 700-707; Berrington de Gonzalez, A., Salotti, J.A., McHugh, K., Relationship between paediatric CT scans and subsequent risk of leukaemia and brain tumours: assessment of the impact of underlying conditions (2016) Br J Cancer, 114, pp. 388-394; Morris, R.J., Double vision as a presenting symptom in an ophthalmic casualty department (1991) Eye, 5, pp. 124-129; Comer, R.M., Dawson, E., Plant, G., Acheson, J.F., Lee, J.P., Causes and outcomes for patients presenting with diplopia to an eye casualty department (2007) Eye, 21, pp. 413-418; Uscher-Pines, L., Pines, J., Kellermann, A., Gillen, E., Mehrotra, A., Emergency department visits for nonurgent conditions: systematic literature review (2013) Am J Manag Care, 19, pp. 47-59; Amos, J.F., Diagnosis and management of monocular diplopia (1986) J Am Ophtalmol Assoc, 53, pp. 101-115; Osorio, M.J., Zuckerbraun, N.S., Painter, M., Acute pupil asymmetry in a 6-month-old boy. Diagnosis: pharmacologic anisocoria (2009) Pediatr Ann, 38, pp. 622-624; Lyons, C.J., Godoy, F., ALQahtani, E., Cranial nerve palsies in childhood (2015) Eye, 29, pp. 246-251; Raucci, U., Vanacore, N., Paolino, M.C., Vertigo/dizziness in pediatric emergency department: five years' experience (2016) Cephalalgia, 36, pp. 593-598; Broder, J., Fordham, L.A., Warshauer, D.M., Increasing utilization of computed tomography in the pediatric emergency department, 2000–2006 (2007) Emerg Radiol, 14, pp. 227-232; Larson, D.B., Johnson, L.W., Schnell, B.N., Rising use of CT in child visits to emergency department in the United States, 1995–2008 (2011) Radiology, 259, pp. 793-801; Korley, F.K., Pham, J.C., Kirsch, T.D., Use of advanced radiology during visits to US emergency departments for injury-related conditions, 1998–2007 (2010) JAMA, 304, pp. 1465-1471
PY - 2017
Y1 - 2017
N2 - Background Acute diplopia (AD) is an uncommon and distressing symptom of numerous ocular and neurological conditions, with potentially serious sequelaes. No data are present in pediatrics on the presentation and management of AD. Aim This study investigated characteristics, etiology and health care utilization of the pediatric population with AD accessed to pediatric Emergency Departments (ED), trying to identify “red flags” associated with potentially life-threatening (LT) conditions. Methods We conducted a cohort multicenter study on children with AD in ten Italian hospitals. Patients were classified into diagnostic categories, comparing children with and without LT disease. Results 621 children presented AD at a rate of 3.6 per 10.000. The most frequent diagnosis among no-LT conditions (81.2%) were headache, ocular disorders and minor post-traumatic disease, while LT conditions (18.8%) were represented by brain tumors, demyelinating conditions, idiopathic intracranial hypertension and major post-traumatic diseases. The LT group showed a significantly higher age, with the odds increased by 1% for each month of age. Monocular diplopia occurred in 16.1%, but unlike adult one-fifth presented LT conditions. Binocular diplopia, associated ocular manifestations or extraocular neurological signs were significantly more common in the LT group. At regression logistic analysis strabismus and ptosis were associated with LT conditions. Conclusion The majority of children presented no-LT conditions and more than one-fourth of patients had headache. Monocular diplopia in the LT group was never isolated but associated with other signs or symptoms. Our study was able to identify some specific ocular disturbances or neurologic signs potentially useful for ED physician to recognize patients with serious pathologies. © 2017 European Paediatric Neurology Society
AB - Background Acute diplopia (AD) is an uncommon and distressing symptom of numerous ocular and neurological conditions, with potentially serious sequelaes. No data are present in pediatrics on the presentation and management of AD. Aim This study investigated characteristics, etiology and health care utilization of the pediatric population with AD accessed to pediatric Emergency Departments (ED), trying to identify “red flags” associated with potentially life-threatening (LT) conditions. Methods We conducted a cohort multicenter study on children with AD in ten Italian hospitals. Patients were classified into diagnostic categories, comparing children with and without LT disease. Results 621 children presented AD at a rate of 3.6 per 10.000. The most frequent diagnosis among no-LT conditions (81.2%) were headache, ocular disorders and minor post-traumatic disease, while LT conditions (18.8%) were represented by brain tumors, demyelinating conditions, idiopathic intracranial hypertension and major post-traumatic diseases. The LT group showed a significantly higher age, with the odds increased by 1% for each month of age. Monocular diplopia occurred in 16.1%, but unlike adult one-fifth presented LT conditions. Binocular diplopia, associated ocular manifestations or extraocular neurological signs were significantly more common in the LT group. At regression logistic analysis strabismus and ptosis were associated with LT conditions. Conclusion The majority of children presented no-LT conditions and more than one-fourth of patients had headache. Monocular diplopia in the LT group was never isolated but associated with other signs or symptoms. Our study was able to identify some specific ocular disturbances or neurologic signs potentially useful for ED physician to recognize patients with serious pathologies. © 2017 European Paediatric Neurology Society
KW - Child
KW - Diplopia
KW - Double vision
KW - Emergency
KW - Life threatening condition
KW - Neuroimaging
KW - acute disease
KW - Article
KW - child
KW - clinical feature
KW - cohort analysis
KW - computer assisted tomography
KW - consultation
KW - controlled study
KW - diplopia
KW - emergency health service
KW - eye disease
KW - female
KW - human
KW - length of stay
KW - major clinical study
KW - male
KW - neuroimaging
KW - neurologic disease
KW - nuclear magnetic resonance imaging
KW - priority journal
KW - ptosis
KW - retrospective study
KW - school child
KW - strabismus
KW - visual disorder
KW - vomiting
KW - adolescent
KW - age
KW - clinical trial
KW - hospital emergency service
KW - hospitalization
KW - Italy
KW - multicenter study
KW - preschool child
KW - Acute Disease
KW - Adolescent
KW - Age Factors
KW - Child, Preschool
KW - Cohort Studies
KW - Emergency Service, Hospital
KW - Female
KW - Hospitalization
KW - Humans
KW - Male
U2 - 10.1016/j.ejpn.2017.05.010
DO - 10.1016/j.ejpn.2017.05.010
M3 - Article
VL - 21
SP - 722
EP - 729
JO - European Journal of Paediatric Neurology
JF - European Journal of Paediatric Neurology
SN - 1090-3798
IS - 5
ER -