Paediatric Neurology Nursing Guide

Paediatric Neurological Assessment

👶Age-Appropriate Neurological Examination

Infant (0–12 months)

Fontanelle: Bulging = raised ICP; sunken = dehydration; closes 9–18 months
Head circumference: Plot each visit; macro (>98th) or micro (<2nd) = red flag; crossing centiles up = hydrocephalus
Primitive reflexes: Moro persisting >6 months = abnormal
Tone: Head lag, ventral suspension; frog-leg = hypotonia
Vision: Fix & follow by 6–8 weeks

Toddler & School Age

Gait: Ataxia, toe-walking, scissoring (CP), steppage (neuropathy)
Coordination: Finger-nose (dysmetria = cerebellar); Romberg
Cranial nerves: CN VII asymmetry; eye movements; tongue deviation
DTRs: Hyperreflexia = UMN; absent = LMN/neuropathy; clonus >3 beats = abnormal
Babinski: Normal extensor to 18 months; beyond that = UMN pathology

🧠Modified Paediatric Glasgow Coma Scale

The standard GCS verbal component cannot be applied to pre-verbal children. Use the modified paediatric GCS below.

Component	Response	Score
Eye Opening (E) Same all ages	Spontaneous	4
	To voice/sound	3
	To pain	2
	None	1
Verbal (V) Paediatric modified	Orientated / coos, babbles (infant: <1yr)	5
	Confused / irritable cry (infant)	4
	Inappropriate words / cries to pain (infant)	3
	Incomprehensible sounds / moans to pain	2
	None	1
Motor (M) Same scoring all ages	Obeys commands / normal spontaneous movement	6
	Localises to pain	5
	Withdraws to pain	4
	Abnormal flexion (decorticate)	3
	Extension (decerebrate)	2
	None	1

        Interpretation: Maximum 15 (normal). Severe = ≤8, Moderate = 9–12, Mild = 13–15. Intubation threshold ≤8 or rapidly falling. Document as E/V/M (e.g., E3V4M5 = 12).
      

📊AVPU Paediatric Scale

Rapid bedside tool — suitable for all ages including infants:

Letter	Meaning	Approx GCS
A	Alert	15
V	Responds to Voice	~13
P	Responds to Pain	~8
U	Unresponsive	<8

P or U = critical — escalate immediately, assess airway

👁Pupil Assessment

Size: Normal 2–5 mm; document exact size both pupils
Reactivity: Brisk, sluggish, or fixed
Asymmetry: Anisocoria >1 mm significant — CN III palsy = ipsilateral dilated/fixed (transtentorial herniation)
Bilateral fixed dilated: Brainstem compromise — emergency
Pinpoint pupils: Pontine lesion or opioid toxicity
Hippus: Rhythmic constriction/dilation — can be normal in children

📈Developmental Milestones — Neurological Red Flags

Age	Expected	Red Flag
6 weeks	Social smile, fix & follow	No social smile; no visual fixation
3 months	Head control, vocalises	Persistent head lag; no vocalisation
6 months	Sits with support, babbles	No babble; fisting; poor head control
12 months	Walks with support, 1–2 words, points	No standing; no words; no pointing
18 months	Walks independently, 10+ words	Regression = urgent; not walking
2 years	2-word phrases, runs	No phrases; regression any domain
3 years	Short sentences, dresses	Unintelligible speech; tremor; falls

Regression in any developmental domain at any age is a neurological emergency until proven otherwise.

📋Seizure History Taking — BEFORE / DURING / AFTER

Before

Aura / prodrome / cry
Activity at onset
Fever; recent illness
Sleep deprivation; missed AED

During

Focal vs generalised
Eye deviation direction
Automatisms (lip smacking)
Cyanosis/pallor; duration; consciousness

After + Background

Post-ictal confusion; Todd's paresis
Previous seizures; AED history
Family history epilepsy/febrile seizures
Perinatal history; developmental baseline

🚨Paediatric Neurological Red Flags

Developmental regression — any domain, any age → urgent

Early morning headache + vomiting → raised ICP → MRI

Petechial rash + fever → meningococcal → IV antibiotics NOW

Persistent headache >4 weeks / new pattern → neuroimaging

Unilateral findings (hemiplegia/hemianopia) → stroke protocol

New ataxia/squint/bulging fontanelle → raised ICP / posterior fossa

Epilepsy in Children

🌡Febrile Seizures

            Simple Febrile Seizure
            Generalised (tonic-clonic)
Duration <15 minutes
Single episode in 24 hours
Child neurologically normal baseline
Rapid full recovery

          

Simple febrile seizures: reassurance, antipyretics, no AED needed. Risk of epilepsy only marginally above general population.

            Complex Febrile Seizure
            Focal onset OR focal features
Duration >15 minutes
Multiple seizures in 24 hours
Post-ictal focal deficit (Todd's)

          

Complex febrile seizure in child <18 months: consider LP to exclude meningitis. EEG + MRI if focal or recurrent complex.

        Parental Guidance: Side position; do not restrain; time seizure; call ambulance if >5 min; nothing in the mouth. Antipyretics for comfort — do NOT prevent recurrence. Recurrence risk ~30% (higher if <12 months or family history). Long-term AED not routinely started.
      

🔬Childhood Epilepsy Syndromes

Syndrome	Key Features	Treatment/Notes
Childhood Epilepsy with Centrotemporal Spikes (CECTS / Rolandic)	Age 3–13; nocturnal focal motor; hemifacial, drooling; normal development; EEG: centrotemporal spikes	Benign, self-limiting — resolves by puberty. AED if frequent or daytime. Levetiracetam/carbamazepine
Continuous Spike-Wave during Slow Sleep (CSWS)	EEG: >85% spike-wave in NREM; language/cognitive regression; epileptic aphasia (Landau-Kleffner)	Valproate, steroids, clobazam; speech therapy; cognitive monitoring
Lennox-Gastaut Syndrome (LGS)	Multiple seizure types (atonic/drop attacks, tonic, atypical absence); intellectual disability; EEG: slow spike-wave 1.5–2.5 Hz	Valproate + clobazam/lamotrigine/rufinamide/cannabidiol (Epidyolex). Helmets for drops. Difficult to control.
Dravet Syndrome	SCN1A gene mutation; febrile-triggered prolonged seizures in first year; later multiple seizure types; intellectual disability; photosensitivity; hyperthermia triggers	Valproate + clobazam/stiripentol/fenfluramine/cannabidiol. CONTRAINDICATED: Sodium channel blockers — carbamazepine, oxcarbazepine, lamotrigine, phenytoin (worsen seizures)
Infantile Spasms (West Syndrome)	Onset 3–12 months; clusters of spasms (flexion/extension); hypsarrhythmia on EEG; regression	First line: ACTH or high-dose prednisolone + vigabatrin. TSC: vigabatrin first line. Urgent treatment — delay worsens cognitive outcomes.
Childhood Absence Epilepsy	Age 4–10; brief staring spells 5–20 sec; 3 Hz spike-wave; triggered by hyperventilation; normal intelligence	Ethosuximide (first line) or valproate or lamotrigine. Remission 70–80% by adolescence.

💊AED Side Effects in Children

Side Effect	Causative AEDs	Monitoring
Weight gain	ValproateVigabatrinCarbamazepine	BMI every visit; nutritional counselling (high obesity rates in GCC)
Cognitive/Behavioural	Topiramate ("Dopa-max") Phenobarbitone Levetiracetam	Topiramate: word-finding, weight loss. Levetiracetam: irritability, aggression
Visual field defect	Vigabatrin	Formal visual field testing every 6 months; irreversible — restrict use
Hyponatraemia	CarbamazepineOxcarbazepine	Monitor Na+; worse with high fluid intake
Hepatotoxicity	Valproate	LFTs + FBC; avoid <2y on polytherapy; contraindicated in POLG mutations
Bone health	PhenytoinCarbamazepinePhenobarbitone	Vitamin D levels; bone density on long-term enzyme-inducing AEDs

⚡Vagus Nerve Stimulator (VNS) — Nursing Care

Device Basics

IPG implanted in left chest wall; electrode on left vagus nerve; parameters set by neurologist
Magnet: Family swipes over device at seizure onset → extra stimulation burst ("magnet therapy")
Battery life 3–5 years; elective IPG replacement needed

Nursing Responsibilities

Document device ID card; alert anaesthesia pre-surgery; no diathermy near device
Side effects: hoarseness, cough during stimulation — normal, reassure family
Teach magnet use; document swipes in seizure diary
Wound infection post-implant: immediate surgical review
MRI: 1.5T conditional — check manufacturer protocol

⏰ Paediatric Status Epilepticus Timer & Drug Calculator

Child's Weight (kg)

Phase: Pre-seizure — Enter weight and press START

00:00

Meningitis & Encephalitis

Petechial rash + fever = meningococcal disease until proven otherwise. Give IV/IM benzylpenicillin or ceftriaxone IMMEDIATELY — do NOT wait for LP.

🦠Bacterial Meningitis — Pathogens by Age

Age Group	Common Pathogens	Empirical Treatment
Neonates (0–28 days)	Group B Streptococcus (GBS), E. coli, Listeria monocytogenes, Klebsiella	Ampicillin + cefotaxime ± gentamicin
Infants 1–3 months	GBS, E. coli, S. pneumoniae, N. meningitidis	Ampicillin + ceftriaxone
Children 3 months – 5 years	N. meningitidis, S. pneumoniae, H. influenzae type b	IV Ceftriaxone + dexamethasone
School age / adolescent	N. meningitidis, S. pneumoniae	IV Ceftriaxone + dexamethasone

Dexamethasone: 0.15 mg/kg IV 4x daily for 4 days. Give 15–20 min before or with first dose of antibiotics. Reduces hearing loss risk in S. pneumoniae meningitis and neurological sequelae.

💉Lumbar Puncture — Indications & Contraindications

Indications

Suspected bacterial meningitis (if safe)
First febrile seizure <12 months (strong), <18 months (consider)
Suspected encephalitis (HSV, autoimmune); IIH

Contraindications — Delay LP

Reduced/fluctuating GCS; focal neurology; papilloedema
Cushing's triad; petechial rash (give antibiotics first)
Coagulopathy / platelets <50; infection at site; haemodynamic instability

CSF Interpretation

Parameter	Normal	Bacterial	Viral	TB
Appearance	Clear	Turbid/purulent	Clear/slightly turbid	Clear/fibrin web
WBC (cells/mm³)	<5	>1000 (PMN)	10–1000 (lymph)	100–500 (lymph)
Protein (g/L)	0.15–0.45	>1.0	Normal/mildly elevated	1–5
Glucose (CSF:blood)	>0.6	<0.4	Normal	<0.5

📞Close Contact Prophylaxis — N. meningitidis

Rifampicin for close household contacts within 24h. Ciprofloxacin single dose in adults. Ceftriaxone in pregnancy.

Drug / Age	Dose
Rifampicin <1 month	5 mg/kg BD × 2 days
Rifampicin 1m–12y	10 mg/kg BD (max 600 mg) × 2 days
Rifampicin >12y	600 mg BD × 2 days
Ciprofloxacin (adult)	500 mg single dose

GCC: Hajj/Umrah — MenACWY vaccine mandatory. W135 and Y strains significant in returned pilgrims from Mecca.

🧪Viral Encephalitis — HSV

Start IV Aciclovir IMMEDIATELY if encephalitis suspected — do NOT wait for PCR result.

Clinical Features

Fever + acute behavioural/personality change
Focal temporal seizures; memory impairment; reduced consciousness
Neonatal HSV: vesicular rash + seizures + multiorgan failure

Investigations & Treatment

MRI: T2/FLAIR temporal lobe signal (hallmark)
EEG: PLEDs in temporal lobes
CSF PCR: HSV-1/2 (can be negative in first 72h)
Aciclovir: 10 mg/kg TDS (neonates: 20 mg/kg) × 14–21 days; monitor renal function

🔮Autoimmune Encephalitis — Anti-NMDAR

Classic: Young female + ovarian teratoma + psychiatric prodrome → orofacial dyskinesias / choreoathetosis → autonomic instability → decreased consciousness

Diagnostic Workup

Serum + CSF NMDAR antibodies (CSF more sensitive)
MRI: often normal or mild T2; EEG: delta brush pattern
Pelvic USS/MRI for ovarian teratoma; whole-body CT/PET if older

Treatment

IV methylprednisolone 30 mg/kg/day × 5 days + IVIG 2 g/kg
Tumour removal if teratoma — essential for remission
Refractory: Rituximab or cyclophosphamide
ICU if autonomic instability; recovery takes months

📉Raised ICP in Meningitis — Management

Position: 30° head up, midline
Fluids: Normovolaemia; 0.9% NaCl/Hartmann's — avoid hypotonic solutions
Hyperosmolar: Mannitol 0.25–1 g/kg IV OR 3% hypertonic saline 3–5 ml/kg
Seizure control: Aggressive — seizures increase ICP

Temperature: Treat fever; avoid hyperthermia
CO₂: Target PaCO₂ 35–40; brief hyperventilation (30–35) only as bridge to definitive care
Avoid: Excessive fluid boluses, hypotension, hyponatraemia, hypoglycaemia

Cushing's Triad: HTN + Bradycardia + Irregular breathing → impending herniation → act immediately

Neurodevelopmental Conditions

🌐Autism Spectrum Disorder (ASD)

DSM-5 Criteria

Domain A: Persistent deficits in social communication (reciprocity, non-verbal communication, relationships)

Domain B: ≥2 of: stereotyped/repetitive behaviour; insistence on sameness; restricted interests; sensory hyper/hyporeactivity

Onset in early development; causes significant functional impairment.

Evidence-based Rx: ABA, speech therapy, OT. Early intervention (<3 years) is critical.

Screening & Hospital Adaptations

M-CHAT-R/F: Screen 16–30 months. Score 0–2 low; 3–7 medium (follow-up); 8–20 high → immediate referral.

Quiet rooms; predictable routines; visual schedules
Social story preparation pre-procedure
Allow comfort objects; minimise staff changes
GCC: cultural acceptance of ASD diagnosis growing; families may initially resist label — sensitive approach required

⚡ADHD — Attention Deficit Hyperactivity Disorder

Subtypes (DSM-5)

Inattentive: Poor attention, forgetful, disorganised, loses things
Hyperactive-Impulsive: Fidgets, interrupts, cannot wait, leaves seat
Combined: Most common — criteria for both

Symptoms in ≥2 settings; onset before age 12; significant functional impairment.

Assessment: Conners Rating Scale (parent + teacher); Vanderbilt Scale; school report essential

Methylphenidate & Monitoring

            Methylphenidate IR: Start 5 mg BD-TDS; titrate 5–10 mg/week; max 60 mg/day (2 mg/kg)

            ER: Concerta / Medikinet XL — once daily

Height/weight (growth suppression — summer drug holidays)
BP, HR, sleep, appetite at each visit
GCC: stimulants are controlled substances — correct documentation + dispensing pathway required

♿Cerebral Palsy

GMFCS (Gross Motor Function Classification System) — Level I to V

Level	Function	Aids Needed
I	Walks without restrictions; limitations in advanced motor skills	None
II	Walks with limitations; difficulty on uneven surfaces, stairs	Handrails
III	Walks with mobility device (walker/crutches)	Walker/crutches
IV	Self-mobility limited; uses powered wheelchair; transported	Wheelchair
V	Full dependence; transported in manual wheelchair; no independent mobility	Full assistance

Spasticity Management

Oral Baclofen: Generalised spasticity; start low; drowsiness risk
Botulinum toxin A: Focal; repeated injections every 3–6 months
ITB pump: Severe generalised spasticity GMFCS III–V
SDR: Surgical; GMFCS II–III ambulant; permanent reduction
Orthoses (AFOs/KAFOs); serial casting; physiotherapy

Associated Issues

Feeding: Oromotor dysfunction; GORD; aspiration; PEG if <80% oral intake
Epilepsy: ~40%; AED management required
Orthopaedic: Annual hip X-ray (migration %); scoliosis surveillance
Positioning: 24-hour postural management; dental care (bruxism)

🧬Intellectual Disability & Down Syndrome

Intellectual Disability Classification

Severity	IQ	Function
Mild	50–70	Independent with support
Moderate	35–50	Semi-independent ADLs
Severe	20–35	Basic self-care with training
Profound	<20	Full dependence

Down Syndrome Annual Monitoring

Thyroid: TSH annually (hypothyroidism 15–20%)
Cardiac: Echo at birth (AVSD most common)
Atlantoaxial instability: C-spine X-ray before contact sport/anaesthesia; neck pain/myelopathy → urgent neurosurgery
Hearing + Eyes: Annual audiogram + ophthalmology
Haematology: FBC (leukaemia risk 10–20× higher)
Dementia: Screen from age 40 (Alzheimer's ~50% by age 60)

Headache in Children

Red flag headaches requiring urgent imaging: Early morning headache waking from sleep + vomiting; worsening over weeks; associated focal neurology; change in headache pattern; first worst headache; triggered by cough/Valsalva; head trauma within 48h; age <5 with severe headache.

💥Migraine in Children

Migraine Features & Triggers

Bilateral (frontal/temporal) in children; pulsating; moderate–severe; nausea/vomiting; photo/phonophobia; 1–72h; worse with activity, relieved by sleep
Triggers: Sleep irregularity, dehydration (critical in GCC heat), skipping meals, screen time, stress, menstruation

Acute & Preventive Treatment

Ibuprofen: 10 mg/kg (max 400 mg) — first line, give early
Paracetamol: 15 mg/kg — alternative/adjunct
Sumatriptan nasal: 10–20 mg (≥12 years)
Domperidone: 0.25 mg/kg — anti-emetic

Preventive: Propranolol 1–2 mg/kg/day (avoid asthma); Topiramate 25–100 mg (cognitive effects); Amitriptyline 0.25–1 mg/kg nocte (ECG monitoring)

Non-pharm: biofeedback, CBT, sleep hygiene, hydration diary

😶Tension-Type Headache

Features: Bilateral pressing/tightening; mild–moderate; no vomiting; no significant photo/phonophobia; not aggravated by activity; 30 min–7 days

Management: Paracetamol/ibuprofen acutely (<15 days/month — avoid medication overuse). Physiotherapy for posture/neck. CBT/relaxation therapy (strong evidence). Address school anxiety. GCC: address screen time and device ergonomics.

📈Raised ICP Headache & Idiopathic Intracranial Hypertension

Raised ICP Features

Worse in morning / lying down / Valsalva
Wakes child from sleep
Associated nausea/vomiting (early morning)
Papilloedema on fundoscopy
New CN VI palsy (false localising sign)
Progressive worsening over weeks

Urgent non-contrast CT brain → MRI if CT negative but strong clinical suspicion. Do NOT perform LP without imaging.

Idiopathic Intracranial Hypertension (IIH)

            Classic: Obese adolescent girl + headache + papilloedema + normal MRI + raised CSF opening pressure (>25 cmH₂O)
          

Risk factors in GCC: Obesity (rising rates), oral contraceptive pill, tetracycline/isotretinoin, vitamin A excess
Investigation: Visual fields (Goldmann/Humphrey) — nasal step defect, enlarged blind spot
LP: Diagnostic AND therapeutic; also monitor opening pressure
Acetazolamide: 25 mg/kg/day TDS (reduces CSF production)
Weight loss: Most effective long-term strategy
VP shunt/optic nerve fenestration: If visual loss threatens

🌡Headache in GCC Children — Context

Dehydration-Triggered Headache

Significant in GCC hot climate (summer 45–50°C); Ramadan fasting = increased risk
Mandatory water breaks during school PE/outdoor sport
Target 1.5–2 L/day; urine pale yellow
Heat stroke: severe headache + altered consciousness → emergency

Screen Time, Posture & Medication Overuse

GCC children: among highest screen time globally → cervicogenic headache + migraine trigger
20-20-20 rule; device-free bedroom; consistent sleep schedule
Medication overuse headache: analgesia >15 days/month → chronic daily headache. Guided withdrawal + preventive start.

GCC Paediatric Neurology Context

🧬Consanguinity & Genetic Neurological Conditions

GCC countries have among the highest rates of consanguineous marriage globally (20–60% in various communities), significantly increasing the prevalence of autosomal recessive neurological conditions.

Conditions with Higher GCC Prevalence

Condition	Genetics	Key Features
Metachromatic Leukodystrophy (MLD)	ARSA gene; AR	Progressive motor + cognitive regression; white matter disease on MRI
GM2 Gangliosidosis (Tay-Sachs/Sandhoff)	HEXA/HEXB; AR; Arab populations	Developmental regression, hypotonia, cherry-red spot, acoustic startle
Gaucher's Disease	GBA gene; AR	Type 3 (neuronopathic): oculomotor apraxia, seizures, cognitive decline
Neuronal Ceroid Lipofuscinosis (NCL)	CLN genes; AR	Progressive myoclonic epilepsy, visual loss, dementia
Krabbe Disease	GALC; AR	Peripheral neuropathy, spasticity, regression in infancy

Genetic Counselling in GCC Context

Pre-marital genetic screening mandatory: UAE, Saudi, Bahrain (haemoglobin disorders + metabolic diseases)
Expanded NBS: Saudi Arabia (30+ conditions), UAE, Qatar
Consanguinity permitted in Islam — counselling must be culturally sensitive and non-judgemental
PGD (preimplantation genetic diagnosis) available in GCC

Child with regression + family history + consanguinity → metabolic workup and genetics referral are priority.

🌿Neural Tube Defects — Prevention & Prevalence

GCC NTD Context

NTD rates historically higher in GCC — folate deficiency + consanguinity
Folic acid flour fortification mandated: UAE, Saudi Arabia, Qatar (400–600 mcg/100g); significant NTD decline post-fortification in Saudi Arabia
Periconceptional folic acid still essential: 400 mcg/day standard; 5 mg/day if high risk (prior NTD, anti-epileptics, diabetes)

Nursing Role in NTD Care

Spina bifida: Clean intermittent catheterisation, bowel programme, latex precautions, VP shunt monitoring for Chiari II
Anencephaly: Palliative care; family support; organ donation discussions
Education: Culturally relevant folic acid messaging for women of reproductive age, including migrant worker communities

⚠Lead Poisoning — GCC Specific Risks

Lead poisoning causes irreversible cognitive impairment and neurological damage. No safe blood lead level exists in children.

GCC-Specific Sources

Traditional kohl (surma/kajal): Applied around eyes of newborns and infants in traditional practice across GCC and South Asian communities — can contain up to 83% lead oxide. AVOID use in children.
Leaded paint: Older buildings; GCC construction boom — migrant worker communities living in older housing stock
Traditional remedies: Some herbal/Ayurvedic preparations contain heavy metals
Contaminated water: Older plumbing (pre-1985 lead solder)

Clinical Features & Management

Neurological: cognitive delay, ADHD-like symptoms, seizures, encephalopathy
GI: abdominal pain, constipation, anorexia
Blood: microcytic anaemia
Basophilic stippling on blood film

Action by Blood Lead Level

<5 µg/dL: No action (previously normal — now ≥3.5 CDC threshold)
5–45 µg/dL: Environmental investigation; source removal; nutritional support (calcium, iron)
>45 µg/dL: Chelation therapy (DMSA oral or CaNa₂EDTA IV); admit to hospital
>70 µg/dL: CRITICAL — IV chelation + ICU

Nursing education: kohl use — inform parents of lead risk respectfully; offer safe alternatives (FDA-approved eye shadow free of heavy metals). Avoid confrontational approach; cultural sensitivity is essential.

🏥Leading Paediatric Neurology Centres in GCC

Centre	Country	Notable Services
BCH / King Fahad Medical City Riyadh	Saudi Arabia	Comprehensive paeds neurology, epilepsy monitoring unit, metabolic neurology
SKMC Neuroscience Institute	UAE (Abu Dhabi)	Paeds + adult neurology, epilepsy surgery, neurointerventional
Cleveland Clinic Children's	UAE (Abu Dhabi)	Paediatric subspecialties incl. neurology; JCI accredited
Sidra Medicine	Qatar (Doha)	Quaternary paeds; genetics; neuroradiology; research
King Faisal Specialist Hospital	Saudi Arabia	BMT for neurometabolic disorders; epilepsy surgery

📚Autism Services in GCC

Key Services by Country

UAE: KHDA Dubai (autism schools + inclusion), Abu Dhabi Centre for Autism (ACA), Amana Healthcare; growing BCBA-certified ABA providers; waitlists 6–18 months
Qatar: Shafallah Centre for Children with Disabilities; Sidra Medicine developmental paediatrics; WISH advocacy
Saudi Arabia: MODON (National Programme for Autism); Prince Salman Centre for Disability Research; private ABA centres expanding rapidly in Riyadh/Jeddah

Nursing Considerations

Families may initially seek diagnosis abroad (UK, USA, Jordan) due to stigma — changing rapidly
Arabic-language resources remain limited — gap area; MOH Saudi digital content improving
Cultural/religious advisors increasingly integrated in GCC autism MDTs
Inclusive education policies improving across GCC — implementation varies by emirate/region

🌡 Febrile Seizure Risk Calculator

Age at seizure (months)

Temperature at time of seizure (°C)

Family history of febrile seizures

Seizure duration

Seizure type

Number of seizures in this episode / 24h

Post-ictal focal deficit (Todd's paresis)

Paediatric Neurology — GCC Nursing Guide