title: [Today and tomorrow in child neurology at a neurological clinic for children--the importance of child neurology as the life-long neurology].
abstract: Segawa Neurological Clinic for Children was founded in 1973, and specializes in neurological disorders that start in childhood. In thirty-one years since the foundation, about 16,000 patients visited this clinic. The ages of the first visit to this clinic of the patients are mostly below 15 years. The main diseases are epilepsy, autism, mental retardation with various etiologies, Tourette syndrome, and other neurological disorders. Most of the diseases follow a chronic course and require long term follow-up. In this clinic those patients who need the continuous follow-up are seen even after reaching to adulthood. The average age of patients who were seen in the clinic during 2003 was about 21 years of age (20.77 +/- 14.28), suggesting that many of the patients are followed in this clinic for 20-30 years. The etiologies and pathophysiologies of most of these diseases are not fully understood. Therefore, the treatments based on the causes are difficult. The pathophysiologies of these diseases are modified by the ages. For example, some patients with epilepsy develop psychiatric symptoms in adulthood, and require the consultation by psychiatrists. The long-term follow up of certain disorders and evaluations of the disorders at different ages up to the adulthood have lead to new scientific discoveries. Examples include age-dependent symptoms observed in Segawa disease, psychiatric symptoms developing in frontal lobe epilepsy cases, alterations of behaviors in autism and Tourette syndrome. This knowledge suggests insights for the early prevention of later adverse outcomes. Social awareness and understanding of these neurological problems occurring in childhood are essential. The medical economic base for child neurology is another challenging and urgent issue to be solved. The importance of child neurology in the life-long neurology is stressed.
authors.affiliation: Segawa Neurological Clinic for Children. nomura_y@kt.rim.or.jp
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Nomura
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000554:Ambulatory Care Facilities / Q000458:organization & administration* / Q000706:statistics & numerical data; D002648:Child; D003266:Continuity of Patient Care; D019988:Children with Disabilities; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007348:Insurance, Health; D007564:Japan / Q000453:epidemiology; D008511:Medicine; D009422:Nervous System Diseases / Q000191:economics / Q000453:epidemiology / Q000534:rehabilitation* / Q000628:therapy*; D009462:Neurology / Q000639:trends*; D010372:Pediatrics / Q000639:trends*; D012017:Referral and Consultation; D013038:Specialization; D013997:Time Factors