Younger children recover faster and have less premorbid conditions than adolescents with concussion (I5-5E)

Objective: To assess demographics, premorbid conditions and clinical course of younger children presenting with concussion. Background: Younger children with concussions are felt to differ from older children and young adults in their risk factors and clinical course, requiring different assessment tools and management plans. Methods: Using a Standardized Clinical Assessment and Management Plan we collected data on 273 patients presenting to a Pediatric Neurology clinic with concussion. Demographic data, clinical presentation, preexisting factors and conditions, diagnostic testing and treatments were collected prospectively and analyzed retrospectively. Results: Data from children 6-10 years (n=51) and 10-20 years (n=222) were collected. Premorbid conditions were common in both age groups. Children with a past medical history of headaches were older (14.37 versus 12.77 years, p<0.001), as were those with any premorbid condition (13.69 versus 11.80 years, p<0.001). 26.6 [percnt] of all children had an individual education plan or medical 504 plan. Older children more frequently reported a history of psychiatric comorbidities (22.9[percnt] anxiety, 8.9[percnt] depression, 15.6[percnt] attention problems) as compared with younger children (9.8[percnt], 0[percnt], 7.3[percnt], respectively). Children 10 years and under had significantly lower symptom scores than older children in all domains (headache, vestibular, cognitive, sleep) except emotional symptoms. Children 10 years or younger recovered more quickly from concussion (mean: 47 versus 75 days, p=0.019). Conclusion: Children of any age who present to Neurology clinic with concussion have a higher rate of premorbid conditions than the population at large, which likely plays a role in prolonged recovery from concussion. Within this population younger children have different clinical characteristics and may recover faster than children >10. Furthermore, there was no difference in emotional symptoms between children <10 and >10 years of age. This may reflect the inability of the post concussive symptoms scale to detect subtle emotional symptoms in younger children. Disclosure: Dr. Guerriero has nothing to disclose. Dr. Hawash has nothing to disclose. Dr. Pepin has nothing to disclose. Dr. Wolff has nothing to disclose. Dr. Meehan III has nothing to disclose.