title: [Demand for neuropediatric care in a regional general hospital. V. Complementary tests].
abstract: BACKGROUND
  Complementary tests orientated by the clinical findings and correctly interpreted, are useful in some cases in order to exclude certain pathologies and on other occasions to help to orientate towards or to confirm diagnoses. Material and methods. In this paper we analyze the complementary tests most often used in children evaluated during a five year period, from May 1990 to May 1995, by a neuropaediatrician who recently joined the staff of the Hospital Miquel Servet in Zaragoza (which had no neuropaediatrician before then).
  
  
  CONCLUSIONS
  Neuroimaging is the technique which was most often useful in establishing the diagnosis. CT or MR orientated or established the diagnosis in 21% of the total number of children evaluated and in 39% of the children in whom this investigation was carried out. The EEG contributed to the diagnosis of epilepsy in 11% of the children. In 16% of the cases of epilepsy the EEG was normal or with nonspecific changes and diagnosis was made on clinical grounds alone. Biochemical tests enabled some pathologies to be ruled out, but contributed to diagnosis on few occasions, most frequently the CSF (basically in meningitis and encephalitis) and muscle enzyme tests were also useful. Routinely used investigations such as those involving amino acids, ammonia, lactate and pyruvate established the diagnosis in a smaller proportion of cases than those used more selectively. Genetics were not found to be very useful in diagnosis. Reallocation of resources is necessary to permit the population as a whole to benefit from the continuous advances being made in techniques of direct study of molecular genetics.
authors.affiliation: Sección de Neuropediatría, Hospital Miguel Servet, Zaragoza, España.
authors.forename: J
authors.initials: J
authors.lastname: López-Pisón
authors.forename: T
authors.initials: T
authors.lastname: Arana
authors.forename: V
authors.initials: V
authors.lastname: Rebage
authors.forename: A
authors.initials: A
authors.lastname: Baldellou
authors.forename: M
authors.initials: M
authors.lastname: Alija
authors.forename: J L
authors.initials: JL
authors.lastname: Peña-Segura
mesh_terms: D001774:Blood Chemical Analysis / Q000706:statistics & numerical data; D002648:Child; D004796:Clinical Enzyme Tests / Q000706:statistics & numerical data; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D004569:Electroencephalography / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008661:Metabolism, Inborn Errors / Q000150:complications / Q000235:genetics; D009422:Nervous System Diseases / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D009462:Neurology / Q000706:statistics & numerical data*; D009468:Neuromuscular Diseases / Q000097:blood / Q000175:diagnosis; D009887:Ophthalmoscopy / Q000706:statistics & numerical data; D010372:Pediatrics / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013030:Spain; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data
vernacular_title: Estudio de la demanda asistencial de Neuropediatría en un hospital de referencia regional V. Exámenes complementarios.