title: Changing profile of 7,519 neurologic outpatients evaluated over 20 years.
abstract: BACKGROUND
  There is scarce information on the demographic profile and diseases affecting neurologic outpatients.
  
  
  METHODS
  We evaluated 7,519 neurologic outpatients over 20 years at the outpatient clinic of the Department of Neurological Sciences, Hospital-Clínica Kennedy, Guayaquil, Ecuador.
  
  
  RESULTS
  Mean age was 48 ± 19.4 years, and 57.8% were women. Common reasons for consultation included headache (33.2%), focal deficits (10.7%), and seizures (9%). The most common categories of neurologic diseases were cerebrovascular (10.6%), degenerative (7.6%), and traumatic (7.1%). Diseases of uncertain/unknown etiology accounted for 50.2% of cases. Young patients were most often evaluated for headache and seizures, while elderly patients usually presented with focal deficits, movement disorders, or cognitive decline. We also found significant variations in the prevalence of neurologic diseases over the study years. While the prevalence of degenerative diseases increased from 5.7% in 1990-1994 to 10.2% in 2005-2009, that of infectious diseases steadily decreased from 3.7 to 2.1% over the study years.
  
  
  CONCLUSIONS
  There was a dynamic pattern of neurologic diseases over the years. Nowadays, distribution of neurologic symptoms and diseases in our population is more similar to that reported from the developed world than it was 20 years ago.
authors.affiliation: School of Medicine, Catholic University, Guayaquil, Ecuador.
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Del Brutto
authors.forename: Daniel
authors.initials: D
authors.lastname: Tettamanti
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Del Brutto
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D004484:Ecuador; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis*; D010045:Outpatients / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation; D013997:Time Factors; D055815:Young Adult