{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:14:52Z","timestamp":1790388892346,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,5,31]],"date-time":"2018-05-31T00:00:00Z","timestamp":1527724800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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\u2010term 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\u20132016). One thousand and forty\u2010nine 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\u2010neurological symptoms. 44.4% patients recovered fully, 23.3% died, 23.3% suffered convalescent or long\u2010term neurological sequelae, and in 8.9% no long\u2010term follow up was available. 57.1% of the patients who died or had a neurological deficit had no documented co\u2010morbidity. 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\u2010term cerebellar dysfunction. Adverse long\u2010term 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\u2010morbid states are at risk of severe heat\u2010related illness. In the face of climate change, effective interventions for heat\u2010related illness, including both treatment and prevention are necessary.<\/jats:p>","DOI":"10.1111\/1742-6723.12990","type":"journal-article","created":{"date-parts":[[2018,5,31]],"date-time":"2018-05-31T04:00:29Z","timestamp":1527739229000},"page":"163-173","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Review article: Environmental heatstroke and long\u2010term clinical neurological outcomes: A literature review of case reports and case series 2000\u20132016"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6785-5797","authenticated-orcid":false,"given":"Emily M","family":"Lawton","sequence":"first","affiliation":[{"name":"Department of Medicine, Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Pearce","sequence":"additional","affiliation":[{"name":"South Australian State Emergency Service  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Genevieve M","family":"Gabb","sequence":"additional","affiliation":[{"name":"Department of Medicine, Royal Adelaide Hospital  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,31]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Climate Change 2013: The Physical Science Basis. Working Group I Contribution to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change","author":"Stocker TF"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra011089"},{"key":"e_1_2_8_4_1","first-page":"525","article-title":"Heatstroke: its clinical picture and mechanism in 36 cases","volume":"36","author":"Shibolet S","year":"1967","journal-title":"Q. J. Med."},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.4103\/1755-6783.115203"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-129-3-199808010-00001"},{"key":"e_1_2_8_7_1","unstructured":"MegarbaneB ResiereD ShabafrouzK DuthoitG. Descriptive study of the patients admitted to an intensive care unit during the heat wave of August 2003 in France.Presse Med. 2003;32: 1690\u20138."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.20.ioi70147"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.jnen.0000186924.88333.0d"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1376-4"},{"key":"e_1_2_8_11_1","first-page":"19","article-title":"Neurological manifestations and their functional impact in subjects who have suffered heatstroke","volume":"56","author":"Laxe S","year":"2013","journal-title":"Rev. Neurol."},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1500-x"},{"key":"e_1_2_8_13_1","first-page":"481","article-title":"Classical heatstroke in Spain. Analysis of a series 78 cases","volume":"94","author":"Jim\u00e9nez\u2010Mej\u00edas ME","year":"1990","journal-title":"Med. Clin. 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