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Neurology at the airport
  1. Araceli Alonso-Cánovas,
  2. Alicia de Felipe-Mimbrera,
  3. Jaime González-Valcárcel,
  4. Nuria García-Barragán,
  5. Iñigo Corral,
  6. Jaime Masjuan
  1. Department of Neurology, Hospital Universitario Ramón y Cajal, Madrid, Spain
  1. Correspondence to Dr Jaime Masjuan, Department of Neurology, IRYCIS, Hospital Universitario Ramón y Cajal, Carretera de Colmenar, km 9.100, 28034 Madrid, Spain; jmasjuan.hrc{at}salud.madrid.org

Abstract

Objectives 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.

Conclusion 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.

  • Air traffic
  • neurological emergencies
  • economy class stroke
  • drugs related emergencies
  • epilepsy
  • alcohol-related problems
  • clinical neurolog
  • fibrinolysis, stroke

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Footnotes

  • Funding AA-C received a grant from the Educational Federation of Neurological Societies (EFNS) educational fellowship in 2009.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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