Acute hemiplegia: aetiology and outcome in Nigerian children

Abstract

Introduction: acute hemiplegia of childhood is a postnatally acquired nonspecific clinical response of the brain to various aetiological insults in a child who was neurologically normal at birth. This study aims at evaluating the aetiology and outcome of acute hemiplegia in children admitted into the University of Calabar Teaching Hospital (UCTH), Nigeria.

Methods: a 5-year retrospective review of all children admitted to the Neurology Unit of the Department of Paediatrics of UCTH with a diagnosis of acute hemiplegia. The demographic characteristics of the children and the clinical features were noted. Investigations including neuroimaging of the brain and haemoglobin genotype were documented. The outcomes of the patients were recorded as either dead, recovered with deficit or loss to follow up. Data obtained was analysed using the SPSS version 24. Simple tables were used to display the results in number and percentages.

Results: twenty-five children with diagnosis of hemiplegia were admitted. Associated clinical features were prolonged seizures (68%), speech defect (32%), cranial nerve deficit (36%) and loss of consciousness (12%). Viral encephalitis was the common aetiology in 11(44%) of the patients, followed by meningitis and sickle cell anaemia in 6(24%) patients each. Four(16%) of the patients recovered completely within the follow up period of three month, 19(76%) had varying degrees of weakness; 2(8%) died. Twelve (48%) were lost to follow-up.

Conclusion: central nervous system infections and sickle cell disease as dominant aetiological factors of acute hemiplegia in Nigerian children. This calls for effective infection control and genetic counselling.