[Neuropaediatrics and primary care. Our experience in the 21st century].

Autor: López-Pisón J; Sección de Neuropediatría, Hospital Universitario Miguel Servet, Avda. Isabel la Católica, 1-3. E-50009 Zaragoza. jlopezpi@salud.aragon.es, Pérez-Delgado R, García-Oguiza A, Lafuente-Hidalgo M, Sebastián-Torres B, Cabrerizo de Diago R, Rebage V, García-Jiménez MC, Baldellou-Vázquez A, Arana-Navarro T, Alonso-Martínez V, Mengual-Gil JM, Bastarós-García JC, Peña-Segura JL
Jazyk: Spanish; Castilian
Zdroj: Revista de neurologia [Rev Neurol] 2008; Vol. 47 Suppl 1, pp. S45-53.
Abstrakt: Introduction: The quality of the health care in a major part of neuropaediatrics benefits from appropriate communication and strategies that have been agreed with primary care (PC) paediatricians.
Patients and Methods: We analyse the children who were assessed in the Neuropaediatric service at the Hospital Universitario Miguel Servet in Saragossa over a period of eight years and we also discuss the most important courses of action followed in the most prevalent problems.
Results: Eight reasons for visiting accounted for 86% of the total number: paroxysmal disorders (33%), headache (27%), psychomotor retardation (11.5%), alterations affecting the shape or size of the head (5.6%), problems at school and/or attention deficit (4.5%), behavioural disorders (4.25%), gait disorders (3.5%) and perinatal distress (3.4%). The most frequent diagnoses are headaches/migraines (26%), non-epileptic paroxysmal disorders (16.5%), prenatal encephalopathy (10.5%), epilepsy (8%), mental retardation (7.5%), infantile cerebral palsy (4.6%), cryptogenic attention deficit hyperactivity disorder (ADHD) (3.8%) and cryptogenic autism (3.6%).
Conclusions: The PC paediatrician working in close relation with the children and their families in all cases is the person mainly responsible for conducting a follow-up on some of the most prevalent problems, such as headaches, many non-epileptic paroxysmal disorders and ADHD. The processes must be established, clearly specified, based on the best evidence, with the participation and within reach of all the professionals involved, in order to favour homogeneity and keep variability in the interventions to a minimum. Channels of communication, including the information and communications technologies, need to be set up to allow health professionals to be permanently up-to-date and capable of controlling their patients in the best possible way.
Databáze: MEDLINE