Changes in Neurology Referrals Before and After the Earthquake: A RetrospectiveReview

Introduction: Earthquakes can disrupt access to healthcare and alter health-seeking behavior, potentially altering the profile of neurology outpatient referrals. Methods and materials: This retrospective study analyzed de-identified, admission-based data from Hatay Mustafa Kemal University Neurology Outpatient Clinic using ICD-10 diagnostic codes, comparing the pre-earthquake period (January 4th, 2021 - February 5th, 2023) with the post- earthquake period (February 6th, 2023 - February 14th, 2025). Results: A total of 185,329 admissions were evaluated (108,524 pre-earthquake and 76,805 post-earthquake). The gender distribution was similar between periods, while admissions among older adults declined after the earthquake. Compared with the pre-earthquake period, the post- earthquake period showed proportional increases in epilepsy, migraine, vertigo/dizziness, and polyneuropathy/neuropathy, with a slight increase in multiple sclerosis; in contrast, proportional decreases were observed for overall pain presentations, anxiety disorders, Alzheimer's disease/dementia, Parkinson's disease, and cerebrovascular diseases. Discussion and conclusions: The February 6, 2023, earthquake was associated with a measurable shift in neurology outpatient referral patterns. These findings support the need for targeted, data- informed post-disaster neurological service planning.