Abstract
BackgroundThe WHO reports excessive rates of ill-defined neurological diagnoses and ineffective and potentially harmful drug treatments in children in the Commonwealth of Independent States (CIS). Collectively termed perinatal encephalopathy and the syndrome of intracranial hypertension (PE-SIH), these diagnoses are important contributors to perceived childhood morbidity and disability in the CIS. A systematic compilation of information on PE-SIH is lacking.MethodsWe systematically reviewed publications between 1970 and 2020 on PE-SIH in Azerbaijani, English, Russian and Ukrainian languages and summarised information on PE-SIH.ResultsWe identified 30 publications (70% in Russian) published 1976–2017. The diagnosis of PE-SIH was either based on unreported criteria (67% of reports), non-specific clinical features of typically developing children or those with common developmental disorders (20% of reports) or cranial ultrasound (13% of reports). The reported proportion of children with PE-SIH in the study samples ranged from 31% to 99%. There were few published studies on reassessments of children diagnosed with PE-SIH, and these did not confirm neurological disease in the majority of children. Treatments included multiple unlicenced drugs without established effectiveness and with potential unwanted effects.ConclusionThis review suggests that PE-SIH is a medical diagnostic label that is used in numerous children without substantive associated disease. The diagnosis and treatment of PE-SIH is a multidimensional, iatrogenic, clinical and public health problem in the CIS. With increasing use of evidence-based medicine guidelines in the region, it is hoped that PE-SIH will gradually disappear, but actions to accelerate this change are nevertheless needed.
Subject
Pediatrics, Perinatology, and Child Health
Reference54 articles.
1. Early childhood development coming of age: science through the life course
2. Overdiagnosis and child health
3. World Health Organization. Regional office for Europe . Inter-country technical consultation on management of neurological conditions in children. Copenhagen: WHO Regional Office for Europe, 2007. http://apps.who.int/iris/bitstream/handle/10665/107875/E91092.pdf;jsessionid=08DE6508BC3F8820272283797FB14F5D?sequence=1
4. Quality of hospital care for children in Kazakhstan, Republic of Moldova, and Russia: systematic observational assessment
5. O terminologii i klassifikatsii porazhenij tsentral'noj nervnoj sistemy u novorozhdennyh i grudnyh detej [Terminology and classification of lesions of the central nervous system in infants];Iakunin;Zh Nevropatol Psikhiatr Im S S Korsakova,1976
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
1. Colin Riddiford Kennedy;Child Neurology;2021