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Mountain neurology
  1. Marieke Cornelia Johanna Dekker1,
  2. Mark H Wilson2,
  3. William Patrick Howlett1
  1. 1 Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
  2. 2 Imperial Neurotrauma Centre, Imperial College Healthcare Trust Biomedical Research Centre, St Mary’s Hospital, London, UK
  1. Correspondence to Dr Marieke Cornelia Johanna Dekker, Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania; marieke{at}


Mountain climbers may develop specific illnesses that largely depend on the altitude reached and the rate of ascent. The popularity of travel to high altitude destinations, extreme tourist activities and mountain climbing means that neurologists in low-altitude countries are increasingly likely to encounter neurological problems and disorders in people exposed to high altitude. Additionally, they may have to advise patients with pre-existing neurological conditions on the risks of ascent to altitude. This article focuses on neurological-related high-altitude illnesses: acute mountain sickness and high-altitude cerebral oedema, as well as high-altitude retinopathy and other neurological disorders. This overview combines current understood pathogenesis with the experience of managing altitude-related illness at the foot of Mount Kilimanjaro in northern Tanzania, the tallest free-standing mountain in the world.

  • acute mountain sickness
  • high-altitude pulmonary oedema
  • high-altitude cerebral oedema

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  • Contributors All authors have contributed equally to this work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data sharing statement Additional unpublished data concern studies the three authors are still working on.

  • Author note Confidentiality: All photographers of the pictures and all individuals depicted in the figures have explicitly provided informed consent. Figure 4 was adapted with permission of author M. Wilson. Further reading: Clarke C. Neurology at high altitude. Practical Neurology 2006; 6: 230-237.

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