Neurological Disorders Occurring at High Altitude on Mount Kilimanjaro, Tanzania Results From a Two Year Referral Centre Survey - Abstract
High-altitude Illnesses (HAI) in the climbing population on Mount Kilimanjaro form a small but steady patient population in our tertiary referral centre. The aim of this study was to document neurological disorders in climbers independent of HAI. Methods: A two year retrospective sampling study was conducted of patients presenting at Kilimanjaro Christian Medical Centre (KCMC) with features suggestive of HAI. Clinical, demographic and altitude-related data were collected through patient record review. Five patients who did not qualify for HAI inclusion who showed neurological signs and symptoms are discussed in more detail. Results: We identified 62 climbers with a diagnosis of HAI related disorders. A total of fifty-six (90%) had classical features of HAI, including acute mountain sickness (AMS) (n=8; 14%), high altitude pulmonary edema (HAPE) (n=30; 54%), HACE (n=7; 12%) and combined HAPE/HACE (n=11; 20%). A total of 6/62 (10%) were found to have non-HAI related disorders. These included five with neurological disorders, three of whom presented with new onset seizures, one with subarachnoid haemorrhage and one with fatal head injury as a result of a fall. One patient with a history of bronchiectasis presented with clinical features suggestive of HAPE but was found to have an exacerbation of bronchiectasis complicated by respiratory tract infection. Conclusion: In a cohort of hospitalised climbers on Mount Kilimanjaro presenting with suspected HAI, a small series of non-HAI related, mostly neurological disorderswere identified. Their onset was also likely to be related to the effects of high altitude.