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Aim: To identify, on a population basis, the prevalence of intellectual disability in children with Dravet syndrome, profiles on a measure of adaptive behaviour, and factors associated with intellectual functioning and adaptive behaviour. Method: Forty‐two out of 48 children with Dravet syndrome living in Sweden, born between 1st January 2000 and 31st December 2018, underwent assessment of intellectual functioning and adaptive behaviour. Factors associated with level of intellectual functioning and adaptive behaviour were analysed. Results: Eight‐six per cent (n = 36) of the children fulfilled DSM‐5 criteria for intellectual disability (29% [n = 12] mild intellectual disability, 24% [n = 10] moderate intellectual disability, 33% [n = 14] severe intellectual disability, 0% profound intellectual disability) and 93% (n = 39) had an adaptive behaviour composite more than two standard deviations below the mean. Communication was a significant weakness compared with daily living skills (p < 0.001; mean difference 95% confidence interval [CI] –8.193 to −4.092) and socialization (p = 0.001; mean difference 95% CI 6.511 to −1.775) on the Vineland Adaptive Behavior Scales, Second Edition. The only factors significantly associated with both decreased adaptive behaviour and presence of severe intellectual disability was the presence of increased autistic symptoms and younger age. Interpretation: Children with Dravet syndrome have a very high level of intellectual disability and almost all have significant deficits in adaptive behaviour. Greater deficits in adaptive behaviour and greater severity of intellectual disability are associated with the presence of increased autistic symptoms, highlighting the need for comprehensive neurodevelopmental assessment for all affected children. What this paper adds: Eighty‐six per cent (n = 36) of children with Dravet syndrome fulfilled criteria for intellectual disability.Ninety‐three per cent (n = 39) of children with Dravet syndrome had significant deficits in adaptive behaviour.Communication was a significant weakness on a measure of adaptive behaviour.Increased autistic symptoms were associated with greater deficits in cognition/adaptive behaviour.Older age and earlier status epilepticus were associated with decreased adaptive behaviour. [ABSTRACT FROM AUTHOR]

Aim: To describe the use of upper‐limb botulinum neurotoxin A (BoNT‐A) treatment in a population‐based sample of children with cerebral palsy (CP), by investigating whether factors may be related to a first upper‐limb BoNT‐A treatment and whether passive range of motion (ROM) is related to a first BoNT‐A treatment after adjustment for confounders. Method: Data from five regions in Sweden, in the national registry and follow‐up programme for CP (CPUP), were collected for children with spastic or dyskinetic CP assessed between 2000 and 2017. CP subtypes, functional classification levels, and traffic‐light‐based passive ROM categories were investigated. Data were analysed with logistic regression (odds ratios). Results: Of a total of 496 children (317 males, 179 females; median 2 years, interquartile range 1–5 years, range 1–15 years at first measurement occasion), 22% (n = 108) had received upper‐limb BoNT‐A treatment, 45% of whom by 1 to 3 years of age. Those classified in Manual Ability Classification System levels IV and V showed the highest crude odds ratio for a first upper‐limb BoNT‐A treatment. Children with full passive ROM with tightness at the end of the movement range were most likely to receive an upper‐limb BoNT‐A treatment, also after adjustment for confounders. Thumb and forearm muscles were the most targeted at the first upper‐limb BoNT‐A treatment. Interpretation: Full passive ROM with tightness at the end of the movement range increases the likelihood of a first upper‐limb BoNT‐A treatment. This new traffic‐light category is an aspect to consider in the dialogue about upper‐limb BoNT‐A. What this paper adds: Among children receiving upper‐limb botulinum neurotoxin A (BoNT‐A), 45% had their first treatment before the age of 4 years.Thumb and forearm muscles were the most treated with BoNT‐A, finger flexor muscles the least.Full passive range of motion with tightness was related to first upper‐limb BoNT‐A treatment. [ABSTRACT FROM AUTHOR]

Aim: To assess a total population of school‐age children with cerebral palsy (CP) for autism and attention‐deficit/hyperactivity disorder (ADHD) with a view to determining their prevalence and to relate findings to motor function, intellectual disability, and other associated impairments. Method: Of 264 children, born between 1999 and 2006, from the CP register of western Sweden, 200 children (109 males, 91 females, median age at assessment 14y, range 7–18y) completed comprehensive screening and further neuropsychiatric clinical assessments. Results: Ninety children (45%) were diagnosed with autism, ADHD, or both, 59 (30%) were diagnosed with autism, and 60 (30%) were diagnosed with ADHD. Intellectual disability was present in 51%. Two‐thirds had autism, ADHD, and/or intellectual disability. In regression models, autism was mainly predicted by intellectual disability (odds ratio [OR]=4.1) and ADHD (OR=3.2), and ADHD was predicted by intellectual disability (OR=2.3) and autism (OR=3.0). Autism was more common in children born preterm (OR=2.0). Gross motor function was not associated with autism. ADHD prevalence was low in children with severe motor impairment, possibly due to diagnostic limitations. Interpretation: Autism and ADHD were common in this population of children with CP and were mainlyindependent of motor severity and CP type. The strongest predictor of autism/ADHD was intellectual disability. Assessment for autism and ADHD is warranted as part of the evaluation in CP. What this paper adds: Forty‐five percent of the children with cerebral palsy also had autism, attention‐deficit/hyperactivity disorder (ADHD), or both.Autism and ADHD were predicted mainly by intellectual disability.Established diagnostic instruments worked well for all but the most disabled group of children. What this paper adds: Forty‐five percent of the children with cerebral palsy also had autism, attention‐deficit/hyperactivity disorder (ADHD), or both.Autism and ADHD were predicted mainly by intellectual disability.Established diagnostic instruments worked well for all but the most disabled group of children. This article is commented on by Gecz and Berry on pages 247–248 of this issue. [ABSTRACT FROM AUTHOR]

Aim: To determine if walking ability and presence of intellectual disability and epilepsy change from childhood to 50 years of age in individuals with cerebral palsy (CP), and if such changes are related to age, sex, or CP subtype.Method: This was a population-based follow-up study of 142 adults born from 1959 to 1978 (82 males, 60 females; mean age 48y 4mo, range 37-58y; 44% unilateral, 35% bilateral, 17% dyskinetic, and 4% ataxic CP) listed in the CP register of western Sweden. We compared childhood data with a follow-up assessment in 2016.Results: At follow-up, walking ability had changed significantly (p<0.001). The proportion of participants walking without aids had decreased from 71% to 62%, and wheelchair ambulation increased from 18% to 25%. Walking ability was related to subtype (p=0.001), but not to age, sex, pain, fatigue, or body mass index. The proportion classified as having intellectual disability had increased from 16% to 22% (p=0.039) and the proportion with epilepsy from 9% to 18% (p=0.015). Of those with childhood epilepsy, 46% were seizure-free without medication.Interpretation: Walking ability and the presence of intellectual disability and epilepsy had changed significantly since childhood. Life-long access to specialized health care is warranted for re-evaluation of impairments, treatment, and assistance. What this paper adds Changes in impairments in individuals with cerebral palsy (CP) over time are related to CP subtype. After 50 years, walking ability in CP may have deteriorated or improved. Intellectual disability in CP may not always be detected in early childhood assessments. Epilepsy in CP may develop after childhood or may be outgrown. [ABSTRACT FROM AUTHOR]

Aim: To describe trends in gastrostomy tube insertion in children with developmental or acquired disorders in Sweden and assess their demographic characteristics.Method: Children aged 0 to 18 years with gastrostomy tube insertions recorded between 1998 and 2014 were identified in the Swedish National Patient Register. Associations between disorder type and year of surgery, as well as age at surgery, were analysed using linear regression analyses. The association between disorder type and mortality 2 years from gastrostomy tube insertion was also analysed using logistic regression analysis.Results: The data for 4112 children (2182 males, 1930 females), with a median age of 2 years (interquartile range=1-8y), were analysed. Children who presented with developmental disorders were the largest group (n=3501, 85%). The most common diagnosis in children with developmental disorders was cerebral palsy (n=165, 4%). In children with acquired disorders, acute lymphoblastic leukaemia (n=117, 3%) was the most common diagnosis. Gastrostomy tube insertions increased from 1998 to 2014, with the greatest increase in children with developmental disorders, who were younger than children with acquired disorders when the gastrostomy tube was first inserted. Age at tube insertion decreased in both groups during the study period. Mortality was higher in children with acquired disorders, suggesting that gastrostomy tube insertion should be part of a palliative care approach.Interpretation: Child characteristics differed depending on whether the underlying disorder was developmental or acquired, suggesting a need for clinical health care guidelines related to the specific goals of gastrostomy tube insertion.What This Paper Adds: Gastrostomy tube insertions increased by 140% from 1998 to 2014 in Sweden. The age of children with developmental disorders decreased by 1 month per year during the study period. Children presenting with developmental disorders were younger than children with acquired disorders when the gastrostomy tube was first inserted. Mortality was higher in children with acquired disorders. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To compare neuroimaging patterns according to the Magnetic Resonance Imaging Classification System (MRICS) in children with cerebral palsy (CP) with and without autism and/or attention‐deficit/hyperactivity disorder (ADHD). Method: This population‐based study assessed 184 children (97 males, 87 females) with CP born from 1999 to 2006 from the CP register of western Sweden, who had completed comprehensive screening and clinical assessment for neuropsychiatric disorders and undergone neuroimaging. Results: Autism (total prevalence 30%) and ADHD (31%) were common in all neuroimaging patterns, including normal. Autism and ADHD were not more prevalent in children with bilateral than unilateral lesions, contrary to other associated impairments. Children with predominant white matter injury, related to insults in the late second or early third trimester, had the highest prevalence of autism (40%). Children who had sustained a middle cerebral artery infarction had the highest prevalence of ADHD (62%). Interpretation: Although autism and ADHD are common regardless of neuroimaging patterns, timing and localization of insult appear to be of importance for the occurrence of autism and ADHD in children with CP. Neuroimaging may be of prognostic value for these associated impairments. Further in‐depth neuroimaging studies may lead to a better understanding of the association between CP and neuropsychiatric disorders. podcast : (https://youtu.be/%5fJXBo055-is) This original article is commented by Kraegeloh‐Mann on page 10 of this issue. [ABSTRACT FROM AUTHOR]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To investigate the stability and to determine factors that affect change in the Gross Motor Function Classification System (GMFCS) in a sample from the total population with cerebral palsy (CP) in two regions of Sweden.Method: Retrospective cohort registry study based on the follow-up programme for CP. Children with CP and a minimum of two GMFCS ratings were included. Subtype, sex, ages at GMFCS ratings, time between ratings, number of ratings, assessor change, and birth cohort were analysed in relation to initial GMFCS levels, with descriptive statistics and logistic regression models.Results: Ninety-three per cent (n=736) of children with CP born between 1990 and 2007 were included, resulting in 7922 assessments between 1995 and 2014. Fifty-six per cent of the children received the same GMFCS rating at all assessments, with a median of 11 individual GMFCS ratings (range 2-21) and a median of three different assessors (range 1-10). Changes were often transient; downward change (higher performance) was more likely in GMFCS levels II and III than in the other levels. The probability of upward change (lower performance) was lowest in unilateral spastic CP.Interpretation: The results support the stability of the GMFCS shown previously and add new information on the properties of the classification. [ABSTRACT FROM AUTHOR]

Aim: To investigate the prevalence of orofacial dysfunction (OFD) and explore factors associated with OFD in young individuals with cerebral palsy (CP).Method: We conducted a cross-sectional study on a population with CP in a Swedish county (132 individuals, mean age 14y 2mo [SD 4y 5mo], range 5-22y) using the Nordic Orofacial Test - Screening (NOT-S), Gross Motor Function Classification System (GMFCS), and Manual Ability Classification System (MACS). The NOT-S interview was completed by 129 individuals (76 males, 53 females) of whom 52 (30 males, 22 females) also agreed to complete the NOT-S examination.Results: OFD occurred in at least one NOT-S domain in about 80% of the individuals and was present in all subdiagnoses, GMFCS levels, and MACS levels. Prevalence of OFD increased with increasing levels of GMFCS and MACS from level I=55% to level V=100%. Within the 12 NOT-S domains, the prevalence of OFD varied between 19% and 69%, wherein seven of them were at least 40%: 'Drooling', 'Nose breathing', 'Chewing and swallowing', 'Face at rest', 'Oral motor function', 'Speech', and 'Facial expression' (in ascending order).Interpretation: OFD is common in CP. The use of OFD screening in health service planning would assist detection of areas in need of further evaluation. [ABSTRACT FROM AUTHOR]

Aim The life expectancy of individuals with cerebral palsy ( CP) is often reduced compared with the general population. Long-term survival with CP is rarely reported. The aim of this study was to investigate survival and the causes of death in relation to CP type and motor and accompanying impairments documented in the CP register of western Sweden over five decades. Method All individuals born between 1959 and 2002 were included in the study. CP was classified according to Hagberg and the Surveillance of Cerebral Palsy in Europe ( SCPE). Motor and accompanying impairments were documented. Causes of death were derived from the National Board of Health and Welfare, and population data were obtained from Statistics Sweden. Log-rank tests with Kaplan-Meier plots were used for statistical analyses. Results Of the 1856 individuals (1033 males, 823 females) with CP included in the study, 180 (9.6%) had died by 31 December 2009. Tetraplegia, dyskinetic CP, severe cognitive impairment, and epilepsy were associated with decreased survival rates. At Gross Motor Function Classification System ( GMFCS) level V, survival rates among individuals with spastic CP were lower than among those with dyskinetic CP. However, compared with the general population, there was an elevated death rate among individuals with CP for all age groups and CP types. At all ages, females with CP had a larger excess risk of death than males. Respiratory failure caused 53% of deaths. For individuals with hemiplegia, as in the general population, 20% of deaths were accidental. Interpretation Survival rates are influenced by CP type but there is an elevated risk of death for individuals with any type of CP, compared with those without CP. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence and incidence of Dravet syndrome in children diagnosed in Sweden between 2007 and 2011, and to describe neurological comorbidity, disease course, phenotypes, and treatment effects.Method: All neuropaediatricians at university and county hospitals were asked to supply information for patients that matched the electro-clinical profile of Dravet syndrome. Genetic laboratories and referral clinicians were also contacted and requested to supply information.Results: The estimated incidence was one in 33 000 live births (95% CI 1:20 400-1:56 200) and prevalence on December 31, 2011 was one in 45 700 children aged less than 18 years of age (95% CI 1:33 800-1:63 400). The median age of the 42 children (18 males, 24 females) was 7 years (range 1-17y), the median age at seizure onset was 6 months (range 0-12mo), and the median age at diagnosis was 3 years (range 1-14y). A mutation in the SCN1A gene was found in 37 patients (88%), four were familial. Intellectual disability was diagnosed in 28 (67%) children, and 18 out of 30 patients investigated had autism spectrum disorder. Thirty participants had neurological deficits. Stiripentol, as an add-on medication, was used in 18 patients. Among these patients, seven were seizure free, six had >50% seizure reduction, and five <50% seizure reduction.Interpretation: This is the first population-based study of Dravet syndrome in Sweden. Our data confirm international findings of incidence and highlights the severe and progressive course of this genetic epilepsy syndrome. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the impact of pre- and perinatal factors on the risk of developing attention-deficit-hyperactivity disorder (ADHD). We investigated the medical history of 237 children (206 male; 31 female) from Malmö, Sweden born between 1986 and 1996 and in whom a diagnosis of ADHD (Diagnostic and Statistical Manual of Mental Disorders-IIIR or IV) was subsequently made at the Department of Child and Adolescent Psychiatry, Lund University, and a reference group of 31 775 typically developing children from Malmö using data from the Swedish Medical Birth Register. The results of multiple logistic regression analysis revealed that ADHD was significantly associated with a young maternal age (odds ratio [OR] for 5y increase 0.87; 95% confidence interval [CI] 0.76-0.99), maternal smoking (OR 1.35; 95% CI 1.14-1.60), maternal birthplace in Sweden (OR 2.04; 95% CI 1.45-2.94), and preterm birth <32 weeks (OR 3.05; 95% CI 1.39-6.71), and a male predominance (OR 6.38; 95% CI 4.37-9.32). Apgar scores at 5 minutes below 7 were significantly associated with ADHD in the univariable analysis (OR 2.60; 95% CI 1.15-5.90). The population-attributable fraction of ADHD caused by the perinatal factors studied was estimated to be 2.8%. The results indicate that the studied factors constitute weak risk factors for developing ADHD. [ABSTRACT FROM AUTHOR]

Aims To investigate cognitive abilities and adaptive skills in children and adolescents with myotonic dystrophy type 1 (DM1) and correlate the findings to the cytosine-thymine-guanine (CTG) repeat expansion size. Method Cognitive level was assessed in 55 children and adolescents with DM1 (31 males, 24 females; mean age 12y 1mo, SD 5y 1mo; range 2y 7mo–21y 5mo) divided into the following categories: severe congenital DM1 ( n=19), mild congenital DM1 ( n=18), and childhood DM1 ( n=18). The Griffiths Mental Developmental Scale, the Wechsler Scales, and the Vineland Adaptive Behavior Scales (VABS) for adaptive skills were used for this purpose. Results Learning disability was found in 95% of the severe congenital group, 83% of the mild congenital group, and 89% of the childhood DM1 group. The more severe the form of DM1, the lower the full-scale IQ (FSIQ; rs=0.28, p=0.044). The individuals with severe congenital and childhood DM1 had a significantly higher verbal IQ than performance IQ (severe congenital: mean difference 5.7, SD 5.7, p=0.008; childhood DM1: mean difference 9.8, SD 18.0, p=0.038). CTG repeat expansion correlated negatively with FSIQ ( rs=−0.63, p<0.006). Almost all participants showed poor results on the VABS. There was a positive relationship between cognitive level and adaptive skills in the mild congenital ( rs=0.95, p<0.01) and childhood DM1 groups ( rs=0.92, p<0.01). Interpretation Children and adolescents with DM1 exhibit significant cognitive and adaptive problems. [ABSTRACT FROM AUTHOR]

In a geographical area of Stockholm, with a relatively large Somali immigrant population, parents as well as teachers in special schools and staff at habilitation centres have raised concerns over whether children with a Somali background are over-represented in the total group of children with autism. The aim of the study was, therefore, to investigate the prevalence of autism in children with parents from Somalia, living in Stockholm county, and to compare the prevalence in children of Somali background with that in the non-Somali group. We reviewed the records of 17 children (13 males, four females), born between 1988 and 1998 (age range 7–17y) and with a Somali background, who had a diagnosis of autistic disorder or pervasive developmental disorder not otherwise specified (PDDNOS) and were registered at either of the two autism habilitation centres for school-aged children. The prevalence of autistic disorder or PDDNOS was found to be three to four times higher than in the non-Somali group (0.7% vs 0.19%). All children also had learning disability. * Our findings warrant further investigations of possible aetiological factors behind the increased prevalence of autistic disorders in children of Somali origin found in this area in Sweden. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe and analyze gross and fine motor function and accompanying neurological impairments in children with cerebral palsy (CP) born between 1991 and 1998 in western Sweden. A population-based study comprised 411 children with a diagnosis of CP ascertained at 4 to 8 years of age. Gross Motor Function Classification System (GMFCS) levels were documented in 367 children (205 males, 162 females). Bimanual Fine Motor Function (BFMF) classification levels of 345 of the children and information on learning disability, epilepsy, visual and hearing impairments, and hydrocephalus from 353 children were obtained. For spastic CP, a new classification according to the Surveillance of Cerebral Palsy in Europe of uni- and bilateral spastic CP was applied. GMFCS was distributed at Level I in 32%, Level II in 29%, Level III in 8%, Level IV in 15%, and Level V in 16%. The corresponding percentages for BFMF were 30.7%, 31.6%, 12.2%, 11.9%, and 13.6% respectively. Learning disability was present in 40%, epilepsy in 33%, and severe visual impairment in 19% of the children. Motor function differed between CP types. More severe GMFCS levels correlated with larger proportions of accompanying impairments and, in children born at term, to the presence of adverse peri/neonatal events in the form of intracranial haemorrhage/stroke, cerebral infection, and hypoxic–ischaemic encephalopathy. GMFCS Level I correlated positively to increasing gestational age. We conclude that the classification of CP should be based on CP type and motor function, as the two combine to produce an indicator of total impairment load. [ABSTRACT FROM AUTHOR]

The suggested link between autism and cerebellar dysfunction formed the background for a Swedish clinical study in 2001. Thirty-two children (17 females, 15 males; mean age 12y, SD 3y 10mo; range 6 to 21y) with a clinical suspicion of non-progressive congenital ataxia were examined, and parents were interviewed about the presence of neuropsychiatric problems in the child. Twelve children had simple ataxia, eight had ataxic diplegia, and 12 had ‘borderline’ ataxia. All but one of the 32 children had a mild to moderate gross motor disability according to Gross Motor Function Classification System (15 were categorized as level I, 16 as level II, and one child as level IV). Neuroimaging and neuropsychological testing were achieved in most cases. There was a strong association between learning disability and autism spectrum disorder (often combined with hyperactivity disorder) on the one hand, and both simple and borderline ‘ataxia’ on the other, but a weaker link between ataxic diplegia and neuropsychiatric disorders. A correlation between cerebellar macropathology on neuroimaging and neuropsychiatric disorders was not supported. Congenital ataxia might not be a clear-cut syndrome of cerebellar disease, but one of many signs of prenatal events or syndromes, leading to a complex neurodevelopmental disorder including autism and learning disability. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the comorbidity pattern, seizure characteristics, and aetiology in a representative group of children with a combination of autism spectrum disorder (ASD), active epilepsy, and learning disability. Ninety children (47 males, 43 females; mean age 11 years 2 months, range 8 to 16 years at the time of psychiatric examination) with active epilepsy and learning disability, identified in a population-based study in Göteborg, Sweden, were subdivided into those with and those without ASD and compared with respect to aetiology, additional neuroimpairments, and seizure characteristics. In addition, the cohorts were examined for trends of prevalence over a period of time. Results indicated that established aetiology was much more often present in the prenatal period than in the peri- or postnatal periods in the ASD group. Cerebral palsy and visual impairment were under-represented in the ASD group. Partial seizures tended to be more common and generalized seizures less common in the ASD group compared with the non-ASD group. Seizure onset was later in the ASD group. Many of the significant differences were accounted for by a large group of psychiatrically unclassifiable participants in the non-ASD group. There was no trend towards an increase of affected children over the 12-year period. There was no increase in the prevalence of active epilepsy and learning disability nor in the rate of autism with active epilepsy and learning disability in children born between 1981 and 1986 compared with those born from 1976 to 1980, indicating no statistical association with the general measles-mumps-rubella vaccination introduced in the early 1980s. [ABSTRACT FROM AUTHOR]

The aims of this retrospective and population-based study were to describe the frequency and characteristics of epilepsy in 146 children (82 males and 64 females) with cerebral palsy (CP) born from 1987 to 1994 in the Göteborg area of Sweden. The frequency of epilepsy was found to be 38% (55 children). All children with tetraplegic CP and about one-third of the children with other CP types developed epilepsy. Age at onset of epilepsy varied with type of CP: children with tetraplegic CP tended to have an earlier onset of epilepsy than children with other CP types. Partial seizures were the most common seizure type; all children with hemiplegic CP had partial seizures. Children with cognitive impairment had a higher frequency of epilepsy than those without cognitive impairment. CP aetiology may predict the development and outcome of epilepsy, as children with CP caused by CNS malformation, CNS infection, and grey matter damage all showed a higher frequency of epilepsy than children with CP of other aetiology, and also had less chance of becoming seizure-free. [ABSTRACT FROM AUTHOR]

The article comments on the study "Survival at 19 Years of Age in a Total Population of Children and Young People With Cerebral Palsy," published within the issue. According to the authors, the study investigated children with cerebral palsy born in Sweden. They say that the study showed that majority of children survive and those who died were more likely to have a lower level of function. They believe that the finding of who survived provides context for planning for the communities and young adults' health care needs.