Neurological disorders in children constitute a major public health challenge worldwide and are among the leading causes of morbidity, disability, and mortality in the pediatric age group. The developing nervous system is particularly vulnerable to a wide range of genetic, congenital, infectious, metabolic, traumatic, vascular, and environmental insults that may occur during the prenatal, perinatal, or postnatal periods. These disorders often result in long-term neurological deficits, impaired cognitive development, reduced quality of life, and significant socioeconomic burden on families and healthcare systems [1].

Childhood neurological disorders encompass a broad spectrum of conditions including epilepsy, febrile seizures, cerebral palsy, developmental delay, central nervous system (CNS) infections, neuromuscular disorders, neurodegenerative diseases, headache disorders, movement disorders, and congenital malformations of the nervous system. The clinical presentation of these conditions varies considerably according to age, etiology, severity, and the region of the nervous system involved. Common presenting complaints include seizures, developmental regression, motor weakness, altered sensorium, abnormal movements, speech impairment, behavioral abnormalities, and learning difficulties [2].

Globally, neurological disorders account for a substantial proportion of childhood disability-adjusted life years (DALYs). The burden is particularly high in developing countries where poverty, malnutrition, inadequate antenatal care, birth trauma, neonatal infections, and limited access to specialized neurological services contribute significantly to disease occurrence and adverse outcomes [3]. In low- and middle-income countries, preventable causes such as perinatal asphyxia, neonatal jaundice, meningitis, encephalitis, and nutritional deficiencies remain important contributors to pediatric neurological morbidity [4].

Epidemiological studies have demonstrated considerable geographical variation in the prevalence and pattern of childhood neurological disorders. Community-based studies from India have reported prevalence rates ranging from 20 to 30 per 1,000 children, with epilepsy, cerebral palsy, developmental disabilities, and intellectual impairment being among the most frequently encountered conditions [5]. A landmark neuroepidemiological study conducted in Bangalore reported that neurological disorders represented a significant health burden in both urban and rural populations, emphasizing the need for systematic surveillance and healthcare planning [6].

Epilepsy is recognized as the most common serious neurological disorder in childhood and contributes substantially to hospital admissions and outpatient consultations. Childhood epilepsy may result from structural brain abnormalities, genetic disorders, infections, metabolic disturbances, or perinatal insults. Early diagnosis and appropriate treatment are essential because uncontrolled seizures can adversely affect cognitive development, academic performance, and psychosocial well-being [7]. Similarly, cerebral palsy remains one of the leading causes of chronic motor disability in children and is frequently associated with epilepsy, intellectual disability, visual impairment, and speech disorders [8].

Central nervous system infections such as meningitis, encephalitis, neurocysticercosis, and tuberculous meningitis continue to be important causes of neurological morbidity in many developing regions. Despite advances in vaccination and antimicrobial therapy, these conditions often result in significant neurological sequelae including epilepsy, hearing impairment, developmental delay, and motor deficits [9]. Developmental disorders and congenital anomalies of the nervous system further contribute to the burden of pediatric neurological diseases and frequently require long-term multidisciplinary management [10].

Hospital-based studies provide valuable insights into the clinical spectrum, demographic characteristics, and disease patterns of pediatric neurological disorders. Such studies help identify the most prevalent conditions requiring specialized care and facilitate resource allocation, service planning, and implementation of preventive strategies. Understanding the clinical profile of neurological disorders among hospitalized children is particularly important in developing countries where reliable epidemiological data remain limited [11].

The present study was therefore undertaken to evaluate the clinical profile of neurological disorders in children presenting to a tertiary care hospital. The study aims to assess the demographic characteristics, clinical presentations, and distribution of various neurological disorders among pediatric patients, thereby contributing to the existing knowledge base and providing evidence for improving pediatric neurological healthcare services.

Study Design and Setting

This hospital-based observational descriptive study was conducted in the Department of Paediatrics, Chennai Medical College Hospital and Research Centre, Tiruchirappalli (Trichy), Tamil Nadu, India. The study was undertaken to evaluate the clinical profile of neurological disorders among children attending the pediatric outpatient and inpatient services of the institution. The study was conducted after obtaining approval from the Institutional Ethics Committee, and informed consent was obtained from parents or legal guardians prior to enrolment.

Study Population

The study included children aged 1 month to 18 years presenting with neurological disorders during the study period. A total of 70 children fulfilling the eligibility criteria were enrolled consecutively.

Inclusion Criteria

• Children aged between 1 month and 18 years.
• Children diagnosed with a neurological disorder based on clinical evaluation and relevant investigations.
• Children whose parents or guardians provided informed written consent for participation.

Exclusion Criteria

• Children with transient neurological symptoms not attributable to a neurological disorder.
• Children with incomplete clinical records or inadequate diagnostic information.
• Parents or guardians unwilling to provide consent.

Sample Size

A sample size of 70 pediatric patients with neurological disorders was included in the study. Consecutive sampling was employed, and all eligible patients presenting during the study period were recruited until the required sample size was achieved.

Data Collection

A structured and predesigned case record form was used to collect data. Detailed demographic information including age, sex, residence, socioeconomic status, birth history, developmental history, immunization status, family history, and relevant past medical history was recorded.

A comprehensive neurological assessment was performed for each participant. Clinical data regarding presenting complaints, duration of symptoms, neurological examination findings, developmental status, cognitive assessment, cranial nerve involvement, motor deficits, sensory abnormalities, gait disturbances, seizure characteristics, and associated systemic manifestations were documented.

Diagnostic Evaluation

The diagnosis of neurological disorders was established based on detailed clinical examination and appropriate laboratory and radiological investigations whenever indicated. The following investigations were performed according to clinical requirements:

• Complete blood count and routine biochemical investigations.
• Serum electrolytes, blood glucose, liver and renal function tests.
• Cerebrospinal fluid analysis in suspected central nervous system infections.
• Electroencephalography (EEG) in children presenting with seizures or epilepsy.
• Neuroimaging studies including computed tomography (CT) scan and/or magnetic resonance imaging (MRI) of the brain.
• Metabolic and genetic investigations when clinically indicated.

Neurological disorders were classified into major diagnostic categories such as epilepsy and seizure disorders, febrile seizures, cerebral palsy, developmental delay, central nervous system infections, neuromuscular disorders, headache disorders, movement disorders, neurodegenerative disorders, and congenital neurological anomalies.

Outcome Measures

The primary outcome measure was the distribution and clinical spectrum of neurological disorders among the study participants. Secondary outcome measures included demographic characteristics, age and sex distribution, presenting symptoms, neurological examination findings, and associated comorbidities.

Statistical Analysis

Data were entered into Microsoft Excel and analyzed using the Statistical Package for the Social Sciences (SPSS) software version 25.0 (IBM Corp., Armonk, NY, USA). Continuous variables were expressed as mean ± standard deviation (SD) or median with interquartile range as appropriate. Categorical variables were summarized as frequencies and percentages. Associations between categorical variables were analyzed using the Chi-square test or Fisher's exact test whenever applicable. A p-value <0.05 was considered statistically significant.

A total of 70 children with neurological disorders were included in the study. The mean age of the study population

was 7.9 ± 4.6 years. Males constituted 42 (60.0%) patients and females 28 (40.0%) patients, yielding a male-to-female ratio of 1.5:1.

Table 1. Age Distribution of Study Participants (n=70)

Table 1 presents the age distribution of children diagnosed with neurological disorders. Among the 70 study participants, the highest proportion belonged to the 1–5 years age group (31.4%), followed by children aged 6–10 years (28.6%). Children aged 11–15 years accounted for 21.4% of cases, while infants younger than one year constituted 8.6% of the study population. The findings indicate that neurological disorders were most frequently encountered during early childhood and school-age years.

Table 2. Gender Distribution of Study Participants

Table 2 shows the gender distribution of the study participants. Of the 70 children included in the study, 42 (60.0%) were males and 28 (40.0%) were females. The male-to-female ratio was approximately 1.5:1, suggesting a higher occurrence of neurological disorders among male children attending the tertiary care center.

Table 3. Clinical Presentation at Admission

Table 3 illustrates the presenting clinical symptoms among children with neurological disorders. Seizures were the most common presenting complaint, observed in 38 (54.3%) patients. Developmental delay was the second most frequent presentation (15.7%), followed by motor weakness (10.0%) and headache (7.1%). Altered sensorium, abnormal movements, and speech disturbances were less common manifestations. These findings highlight seizures as the predominant reason for pediatric neurological consultation and hospitalization.

Table 4. Spectrum of Neurological Disorders Diagnosed

Table 4 depicts the spectrum of neurological disorders diagnosed among the study participants. Epilepsy and seizure disorders represented the largest diagnostic category, accounting for 40.0% of cases. Febrile seizures constituted 14.3% of cases, while cerebral palsy accounted for 12.9%. Central nervous system infections were diagnosed in 11.4% of children. Developmental delay/intellectual disability, neuromuscular disorders, headache disorders, movement disorders, and congenital neurological disorders comprised smaller proportions. The results demonstrate that seizure-related disorders form the major burden of pediatric neurological diseases in the study setting.

Table 5. Neuroimaging Findings (n=70)

Table 5 summarizes the neuroimaging findings among the enrolled children. Normal neuroimaging results were observed in 45.7% of patients. Among abnormal findings, cerebral atrophy was the most frequently identified abnormality (14.3%), followed by periventricular leukomalacia (11.4%) and structural brain malformations (8.6%). Hydrocephalus and infective lesions were each detected in 7.1% of patients, while space-occupying lesions accounted for 5.8%. These findings indicate that neuroimaging plays a crucial role in identifying structural abnormalities associated with pediatric neurological disorders.

Table 6. Association Between Age Group and Seizure Disorders

Table 6 evaluates the association between age group and seizure disorders. Seizure disorders were observed across all age groups but were particularly common among children aged 1–5 years (68.2%) and those older than 15 years (85.7%). Statistical analysis demonstrated a significant association between age category and the occurrence of seizure disorders (Chi-square = 9.21, p = 0.048). This finding suggests that age may influence the pattern and frequency of seizure-related neurological presentations in children.

Figure 1 illustrates the distribution of presenting neurological symptoms among the 70 children included in the study. Seizures were the most frequently reported presenting complaint, occurring in 38 children (54.3%), indicating that seizure-related disorders constituted the predominant reason for neurological evaluation and hospitalization. Developmental delay was the second most common presentation, observed in 11 children (15.7%), followed by motor weakness in 7 children (10.0%). Headache was reported in 5 children (7.1%), while altered sensorium and abnormal movements were noted in 4 (5.7%) and 3 (4.3%) children, respectively. Speech disturbance was the least common presenting symptom, affecting 2 children (2.9%). The findings demonstrate that seizure manifestations account for the majority of pediatric neurological presentations, whereas developmental and motor impairments represent important secondary clinical concerns.

Figure 2 illustrates the distribution of seizure disorders and other neurological disorders across different age groups. Seizure disorders were observed in all age categories, with the highest proportion occurring among children aged >15 years, where 85.7% of patients in that age group presented with seizure disorders. A high prevalence was also noted among children aged 1–5 years (68.2%). In contrast, children aged 6–10 years and 11–15 years showed a greater proportion of non-seizure neurological disorders. Infants younger than one year demonstrated a relatively lower frequency of seizure disorders (33.3%). Statistical analysis revealed a significant association between age group and the occurrence of seizure disorders (Chi-square = 9.21, p = 0.048), indicating that age may influence the pattern of neurological presentations among pediatric patients.

The present hospital-based study evaluated the clinical profile of neurological disorders among 70 children attending a tertiary care teaching hospital. Neurological disorders constitute a significant proportion of pediatric morbidity and frequently require specialized multidisciplinary management. The findings of the present study demonstrated that seizure-related disorders were the predominant neurological conditions, with epilepsy and febrile seizures accounting for more than half of all cases. These observations are consistent with previous pediatric neurology studies that have identified seizure disorders as the leading cause of neurological consultations and hospital admissions among children [12,13].

The age distribution of the study population revealed that the majority of affected children belonged to the 1–5 years age group, followed by children aged 6–10 years. Similar age patterns have been reported in several pediatric neurology clinics where neurological disorders are commonly diagnosed during early childhood owing to increased vulnerability of the developing brain and the emergence of developmental, epileptic, and congenital neurological conditions during this period [14]. Early childhood represents a critical phase of neurological maturation, and insults occurring during this stage often manifest clinically through seizures, developmental delay, and motor impairments.

A male predominance was observed in the present study, with males accounting for 60% of the study population. Similar findings have been reported by earlier studies from both developed and developing countries [15,16]. The higher proportion of males may reflect a combination of biological susceptibility, greater prevalence of certain neurological disorders among boys, and sociocultural factors influencing healthcare-seeking behavior. Several neurodevelopmental disorders, including epilepsy, developmental delay, and cerebral palsy, have been reported more frequently among male children [15]. Seizures constituted the most common presenting symptom, affecting more than half of the participants. This finding is comparable to observations reported by Sidenvall et al. and Berg et al., who highlighted seizures as the most frequent neurological presentation requiring specialist evaluation in childhood [17,18]. The predominance of seizures may be explained by the relatively high incidence of epilepsy, febrile seizures, central nervous system infections, and structural brain abnormalities during childhood. Seizures often serve as the initial manifestation of an underlying neurological disorder and therefore account for a substantial proportion of pediatric neurology referrals.

Developmental delay emerged as the second most common presenting complaint. This finding is in agreement with the practice parameter published by Shevell et al., which emphasized developmental delay as one of the most common reasons for pediatric neurological assessment [10]. Developmental delay frequently results from perinatal brain injury, genetic abnormalities, metabolic disorders, cerebral palsy, and neurodevelopmental syndromes. Early recognition and intervention are essential because delayed diagnosis may adversely affect cognitive, language, and social outcomes.

Regarding the spectrum of neurological disorders, epilepsy and seizure disorders represented the largest diagnostic category, accounting for 40% of all cases. Similar findings have been documented in epidemiological studies by Hauser et al. and Sillanpää and Shinnar, who reported epilepsy as the most prevalent serious neurological disorder during childhood [19,20]. The substantial burden of epilepsy observed in the present study highlights the need for improved diagnostic facilities, electroencephalographic services, and long-term follow-up programs within tertiary healthcare institutions. Febrile seizures constituted the second most common diagnostic category. This observation is consistent with previous literature demonstrating that febrile seizures affect approximately 2–5% of children and represent one of the most common neurological emergencies encountered in pediatric practice [21]. Although generally benign, febrile seizures remain a significant cause of parental anxiety and hospital visits.

Cerebral palsy accounted for 12.9% of neurological disorders in the present study. This finding is comparable to reports by Bax et al., who identified cerebral palsy as the most common cause of chronic motor disability in childhood [8]. The persistence of cerebral palsy in developing countries is frequently associated with preventable factors such as birth asphyxia, prematurity, neonatal infections, and inadequate perinatal care. The burden observed in the present study underscores the importance of strengthening maternal and neonatal healthcare services. Central nervous system infections represented an important proportion of neurological disorders. Similar observations have been reported by Singhi, who emphasized that meningitis, encephalitis, neurocysticercosis, and tuberculous meningitis continue to contribute substantially to pediatric neurological morbidity in developing nations [9]. Despite advances in vaccination and antimicrobial therapy, CNS infections remain important causes of seizures, developmental impairment, hearing loss, and long-term neurological disability.

Neuroimaging findings demonstrated that nearly half of the patients had normal radiological studies, while cerebral atrophy and periventricular leukomalacia were the most common abnormalities identified. Comparable findings have been reported in studies evaluating neuroimaging in pediatric epilepsy and developmental disorders, where structural abnormalities are detected in a subset of patients while many children exhibit normal imaging despite significant clinical manifestations [22]. The identification of cerebral atrophy and periventricular leukomalacia suggests the contribution of perinatal hypoxic-ischemic injury and neurodevelopmental abnormalities to the disease burden.

The present study also demonstrated a statistically significant association between age group and seizure disorders. Seizure disorders were particularly frequent among children aged 1–5 years and those older than 15 years. Similar age-related variations have been reported in epidemiological studies of pediatric epilepsy, reflecting differences in etiological factors and neurodevelopmental vulnerability across age groups [20]. The finding emphasizes the need for age-specific diagnostic approaches and preventive strategies in pediatric neurological practice. Overall, the findings of the present study highlight the predominance of seizure disorders, developmental disabilities, cerebral palsy, and CNS infections among children attending a tertiary care center. Early diagnosis, timely referral, improved neurodiagnostic facilities, and multidisciplinary rehabilitation services are essential for reducing the burden of childhood neurological disorders and improving long-term outcomes.

Neurological disorders constitute a significant cause of pediatric morbidity and represent an important healthcare challenge in tertiary care settings. The present study demonstrated that seizure-related disorders, including epilepsy and febrile seizures, were the most common neurological conditions encountered among children, with seizures being the predominant presenting symptom. Early childhood was the most frequently affected age group, and a male predominance was observed. Cerebral palsy, central nervous system infections, developmental delay, and neuromuscular disorders also contributed substantially to the overall disease burden.

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