title: Neurology at the airport.
abstract: OBJECTIVE
  Neurological problems are reported to be common in air travellers. The authors aimed to study neurological problems which might be associated with air traffic in a systematic way.
  
  
  METHODS
  The authors analysed a prospective registry of all the patients referred from Madrid-Barajas International Airport to the emergency department of their tertiary university hospital (Hospital Universitario Ramón y Cajal), for whom a neurological consultation was required, during a period of 21 months.
  
  
  RESULTS
  77 patients with a history of air travel presented with neurological problems and were included in the analysis. Fifty-nine (76.6%) were male, and the mean age was 45.9 (range 8-89, SD 17.5). Onset of symptoms was after landing in 44 subjects (58.7%), during the flight in 31 (41.3%), and unknown in two (5.1%). Thirty-nine (50.9%) had seizures, 18 (23.4%) had a stroke, and 20 (26%) other diagnosis. Sixty-one per cent of the patients with seizures had no previous history of epilepsy. Seizures on presentation were significantly associated with the use of drugs (p = 0.0008), and most of the cases with known epilepsy admitted non-adherence to treatment. Three 'body packers' were admitted with seizures secondary to intra-abdominal cocaine pack rupture. Of eight ischaemic strokes, five had high-grade carotid stenosis, and one case had economy-class stroke syndrome. Six patients with stroke were eligible and treated with intravenous thrombolysis.
  
  
  CONCLUSIONS
  In our series of neurological problems among air travellers, drug-induced seizures and ischaemic strokes due to large-artery atherosclerosis were the commonest observed diagnoses.
authors.affiliation: Department of Neurology, IRYCIS, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Araceli
authors.initials: A
authors.lastname: Alonso-Cánovas
authors.forename: Alicia
authors.initials: A
authors.lastname: de Felipe-Mimbrera
authors.forename: Jaime
authors.initials: J
authors.lastname: González-Valcárcel
authors.forename: Nuria
authors.initials: N
authors.lastname: García-Barragán
authors.forename: Iñigo
authors.initials: I
authors.lastname: Corral
authors.forename: Jaime
authors.initials: J
authors.lastname: Masjuan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059028:Airports; D000428:Alcohol Drinking; D001359:Aviation; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000150:complications; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D002546:Ischemic Attack, Transient / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012640:Seizures / Q000453:epidemiology; D013226:Status Epilepticus / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000150:complications; D014195:Travel; D055815:Young Adult