Abstracts

Rationale: To assess the outcome of urgent neurological referrals by pediatricians and the need for an urgent seizure clinic in pediatric neurology.Methods: This is a retrospective review of all urgent referrals to our pediatric neurology clinic by direct phone call request from pediatricians during a one month period. All patients, at the time of referral, reportedly had a non-focal examination.Results: The total number of patients urgently referred was 30. Patients were scheduled within 2 weeks. Six patients (20%) did not show up for their scheduled visit. The remaining patients were classified into five groups depending on their neurological assessment: Group A, patients with no further need for testing or evaluation; Group B, patients that required further diagnostic testing; Group C, patients that were prescribed medication; Group D, patients who met criteria for both Groups B and C; Group E, patients that were admitted to our inpatient ward. Based on this classification scheme of 24 patients, 12 (50%) were placed in Group A, 4 (16%) were placed in Group B, 5 (20%) were placed in Group C, 2 (8%) in Group D and 1 (4%) in group E. The most common reason for referral was clinical seizures-10 out of 24 patients (41%). Of those, 7 patients were referred for new onset seizures; 3 had immediate diagnostic evaluation; 3 patients had breakthrough seizures and 3 were prescribed antiepileptic medication when testing was completed. Conclusions: This study shows that among patients urgently referred to pediatric neurology, almost half of the patients were evaluated for seizures. There is a growing demand for pediatric neurology services and wait times for routine appointments are long [1, 2]. In order to meet this increasing demand, we have found it helpful to create an increased number of urgent visits slots, particularly urgent seizure clinic visits, into our current schedules. References: 1. Child neurology: Past, present, and future: part 1: history. Millichap JJ, Millichap JG. Neurology. 2009 Aug 18;73(7):e31-3. 2.The Child Neurology Workforce Study: Pediatrician access and satisfaction. Bale JF Jr, Currey M, Firth S, Larson R; Executive Committee of the Child Neurology Society. J Pediatr. 2009 Apr;154(4):602-606.