Editorial

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Excerpt

Mortality has fallen for many of neurological conditions in childhood, which has exposed the need for data on morbidity and its predictors, particularly if it may be preventable, for example with vaccination for infectious disease [1]. The economic cost of chronic neurological conditions in childhood is very substantial. In addition to the cost of acute treatment and rehabilitation for those who need it, for example after traumatic brain injury or stroke [2], life expectancy, although reduced, may be much closer to that of the typically developing child than many physicians appreciate [3,4]. The conditions in this section on neurodevelopmental disorders typically come on relatively suddenly in child with or without previous problems and have a cost in terms of cognition in a substantial proportion of the patients. For an initial presentation with epilepsy in the clinic, just as for acute presentation with, in-of-hospital or out-of-hospital cardiac arrest, stroke or neurological complications of essential treatment, such as brain tumor or cardiopulmonary bypass, the first question that parents and physicians want answered is ‘How is s/he going to be in the long term?’ The families then want to know what can be done to optimize outcome for their own child. If the attending physicians cannot supply answers to either of these questions, they usually turn to alternative sources of information from social media, including family support groups as well as the internet. Despite this high level of anxiety for all those involved, especially if there may be a medicolegal claim in countries where no-fault compensation [5] is not available, there has been a paucity of long-term outcome data to inform conversations with families and to act as endpoints in essential trials of treatment.
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