Healthcare management of children with an acquired demyelinating syndrome in the Czech Republic

Česká verzia

Authors: T. Toman ¹; A. Svěráková ¹; P. Kršek ¹; Z. Libá ¹; Projekt Demon
Authors place of work: Neurologické oddělení, Nemocnice Jihlava ²; Dětská klinika Masarykovy nemocnice, Ústí nad Labem ³; Dětské oddělení, Oblastní nemocnice Kolín ⁴; Klinika dětské neurologie, LF MU a FN Brno ⁵; Neurologická klinika LF UK a FN Plzeň ⁶; Klinika dětského a dorostového lékařství, 1. LF UK a VFN v Praze ⁷; Pediatrické oddělení, FN Bulovka, Praha ⁸; Ambulance dětské neurologie, Jablonec nad Nisou ⁹; Dětské a novorozenecké oddělení, Pardubická nemocnice ¹⁰; Oddělení dětské neurologie, Fakultní, Thomayerova nemocnice, Praha ¹¹; Ambulance dětské neurologie, České Budějovice ¹²; Neurologická klinika LF OU a FN Ostrava ¹³; Dětské oddělení, Krajská nemocnice, Tomáše Bati, Zlín ¹⁴; Neurologická klinika, LF UK a FN Hradec Králové ¹⁵
Published in the journal: Cesk Slov Neurol N 2024; 87(3): 191-196
Category: Original Paper
doi: https://doi.org/10.48095/cccsnn2024191

Summary

Aim: The aim of this study was to investigate the distribution and extent of healthcare provided to children with a suspected acquired demyelinating syndrome (including acute disseminated encephalomyelitis, clinically isolated syndrome, multiple sclerosis and neuromyelitis optica spectrum disorder) and to identify areas for care improvement in the Czech Republic. Patients and methodology: Electronic questionnaire survey at all inpatient departments of pediatric neurology (N = 7) and pediatric departments (N = 22) at the regional and university hospital level. Responses were obtained from all contacted hospitals. Results: All inpatient departments of pediatric neurology and 10 pediatric departments are involved in the care of patients. All have the necessary diagnostic methods available, but therapeutic options differ. We identified specific differences in the diagnostic approach -in the indication and interpretation of examinations and in the use of current diagnostic criteria. In six regions, care is provided primarily by departments of pediatric neurology. In the remaining eight regions, patients are admitted to pediatric departments with an available pediatric neurology consultant. More complex cases are transferred to pediatric neurology departments, where the diagnostic approach is more comprehensive and the therapeutic options are more extensive. Conclusion: In the Czech Republic, healthcare for children with an acquired demyelinating syndrome is at a high level, but it is not standardized. The most appropriate standard of care is provided in specialized care centers for multiple sclerosis and neuromyelitis optica spectrum disorders. Given the distribution of care, specialized education must also include pediatricians and pediatric neurology consultants.

Keywords:

Pediatrics – Multiple sclerosis – Czech Republic – demyelinating autoimmune disorders – care management – tertiary care centers

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