TY  - JOUR
PY  - 2019//
TI  - Review article: environmental heatstroke and long-term clinical neurological outcomes: a literature review of case reports and case series 2000-2016
JO  - Emergency medicine Australasia
A1  - Lawton, Emily M.
A1  - Pearce, Helen
A1  - Gabb, Genevieve M.
SP  - 163
EP  - 173
VL  - 31
IS  - 2
N2  - Global temperatures are rising; extreme environmental heat can result in adverse health effects including heatstroke. Acute effects of heat are well recognised, but there is less understanding of potential long-term adverse outcomes. Our aim was to review recent medical literature for clinical cases of environmental heatstroke with a focus on neurological outcome. Structured search strategies were designed to retrieve publications of heatstroke case reports using Ovid Medline and Embase (2000-2016). One thousand and forty-nine abstracts were identified, and after application of exclusion criteria 71 articles deemed relevant. Ninety cases were identified from 71 articles. 100% presented with acute neurological symptoms; 87.8% presented with non-neurological symptoms. 44.4% patients recovered fully, 23.3% died, 23.3% suffered convalescent or long-term neurological sequelae, and in 8.9% no long-term follow up was available. 57.1% of the patients who died or had a neurological deficit had no documented co-morbidity. Patterns of neurological deficits included 66.7% patients with motor dysfunction, 9.5% cognitive impairment, 19% both motor and cognitive impairment and 4.7% other. In total 71.4% of the impaired patients had long-term cerebellar dysfunction. Adverse long-term neurological outcomes were common in surviving patients presenting with environmental heatstroke. Permanent neurological deficits were present in 34.4% of survivors where outcome was known; many were young, healthy individuals. Cerebellar injury was common suggesting cerebellar structures are vulnerable to heat. These findings highlight that people of all ages and pre-morbid states are at risk of severe heat-related illness. In the face of climate change, effective interventions for heat-related illness, including both treatment and prevention are necessary.<br><br>© 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.<p />  <p>Language: en</p>
LA  - en
SN  - 1742-6731
UR  - http://dx.doi.org/10.1111/1742-6723.12990
ID  - ref1
ER  -