Experience of a neurology service during the 2016 Olympic and Paralympic Games.

Background: We analyzed the utilization of acute neurologic care during the 2016 Olympic and Paralympic Games in Rio de Janeiro.
Methods: We conducted a retrospective analysis of data collected during the games.
Results: Sixty-three neurologic evaluations were performed in patients from the Olympic Family (OF), 22 of these involving athletes from 19 countries. Traumatic brain injuries (TBIs) were the most frequent reason for assessment among athletes, some associated with polytrauma. Four patients were admitted to the neurocritical care unit (NICU): 2 acute ischemic strokes, 1 TIA, and 1 polytrauma with moderate TBI. Among nonathletes, evaluation of TBI associated with motor vehicle accidents was surprisingly high, with 10 assessments, none requiring admission. Also, nonathletes with seizures, multiple sclerosis flare, functional deficits, and psychiatric complaints received neurologic evaluation. During the Paralympic Games, 17 neurologic evaluations were performed in patients from the Paralympic Family (PF), 13 involving athletes from 10 countries. Five athletes presented with mild TBI. One PG training coach was admitted to the NICU after receiving alteplase for an acute ischemic stroke.
Conclusions: As expected, many athletes with sports-related injuries were evaluated, but cases of diverse acute neurologic pathologies were observed among nonathlete members of the OF and PF. Olympic Games are large, logistically complex events involving thousands of people. Our observations suggest that a comprehensive and detailed plan for neurologic emergencies should be considered for future games.