A multi-institutional collaborative study was conducted concerning the course of pregnancy and delivery and the incidence of abnormal infants delivered of epileptic women. Of 657 women receiving antiepileptic drugs, 73% delivered live infants, 14% had miscarriage or stillbirth, and 13% underwent induced abortion. In contrast to the above findings, 80% of 162 patients not receiving antiepileptic drugs delivered live infants and 4% had miscarriage or stillbirth. The latter outcome was significantly increased in the medicated patients. In this series, 63 (9.9%) of 638 live births were malformed, 55 (11.5%) being from medicated mothers and 3 (2.3%) from nonmedicated mothers. The incidence of fetal malformation in medicated mothers was thus five times as high as that in nonmedicated mothers. Cleft lip and/or palate and malformations involving the cardiovascular system were found frequently in the infants from medicated mothers. General background factors that might exert teratogenic effects on pregnant patients with epilepsy were studied, and the potential toxicity of antiepileptic drugs to the fetus was also analyzed. In this regard, consideration should be given to whether the patient has partial epileptic seizures, whether the patient herself exhibits any malformation, or whether her previous pregnancy resulted in an abnormal outcome. The incidence of fetal malformation was the highest (12.7%) in the medicated patients who had epileptic seizures during the pregnancy. It is presumed on the basis of the results of analysis of the data that a combination of more than three drugs and a daily dose greater than a certain minimal level is likely to produce malformed infants.

A multi-institutional study on the prognosis of patients with epilepsy was performed in Japan from 1975 to 1977, including 20 institutions. The outcome of epileptic seizures and social adjustment 10, 5, and 3 years after the onset of the illness was studied in three different groups of epileptic patients, respectively. The number of successfully followed-up cases was 1,868 in total, follow-up rate being 42%. The data were analyzed statistically by use of analysis of variance. The rate of remission of seizures in all was 58.3% and the rate of normal social adjustment 62.6%. The remission rate showed no significant difference among the 10-, 5-, and 3-year outcome groups. The study on the outcome of seizure control indicated that the prognosis of seizure control is more favorable (a) in idiopathic than in residual or symptomatic epileptics; (b) in patients with onset before 10 years of age than in those with onset after 10 years; (c) in patients with less frequent seizures; (d) in sleep epilepsy than in waking and diffuse epilepsies; (e) in patients who started treatment within 1 year of onset of seizure; (f) in patients with single-type partial seizures than in those with partial seizures combined with tonic-clonic seizures; (g) in patients without high grade EEG background abnormality; and (h) in patients without neurological symptoms, intellectual deficits, personality disturbances, or psychotic symptoms. Factors that determine the prognosis of social adjustment were almost similar to those for remission of seizures. There was a close correlation between the outcome of seizure control and that of social adjustment. Correlation coefficient between follow-up rate and remission rate in 15 of the 20 collaborated institutions was 0.55 (p less than 0.05), showing a tendency that the remission rate becomes higher as the follow-up rate is raised.

This study examines the incidence rate of setback in 80 autistic children, the correlation between the type of onset and clinical features, developmental level and prognosis based on an originally developed questionnaire. Moreover, this study seeks to investigate the possibility that infantile autism might be classified into subgroups by the type of onset. The acquired (including questionably acquired) group consisted of 39 cases (49%), while the natal group was made up of 41 cases (51%). The age when the setback occurred was 21–22 months in the acquired group. Precipitating psychological events were observed in 22 cases (56%) of the acquired group. The mental developmental level including speech and sociability function at 5 years of age was significantly lower in the acquired group than in the natal group. The acquired group showed severe behavioral disorderssuch as “stereotypic behavior,”“extremely hyperkinetic behavior” and “self‐abusive behavior” compared with the natal group. The adaptive levels at schools or institutions were lower in the acquired group than in the natal group. There was a higher incidence of epileptic seizures orfebrile convulsions in the acquired group than in the natal group. Moreover, there was a higher incidence of severe perinatal abnormalities in the acquired group. The above‐mentioned results suggest that infantile autism might be classified into two subgroups, acquired and natal groups, based on the typeof onset, and also suggest that some types of brain dysfunctions are more severe in the acquired group than in the natal group.

For the purpose of clarifying the pathophysiological meaning of sleep disturbance in autistic children, the sleep pattern of 75 such children was examined by a questionnaire method. Forty‐nine of them showed sleep disturbance in their early life with an incidence of 65%. The poorly‐developed group showed a high rate of sleep disturbance as compared with the relatively well‐developed group. There was a negative correlation between the developmental level and duration period of sleep disturbance. The investigation of circumstances in which autistic children often exhibited sleep disturbance proved that abrupt changes in life environment or various problems in the way of bringing up children brought about their sleep disturbance. These findings suggest that sleep disturbance might be one of the main symptoms and related to the pathophysiology of infantile autism.

Examined hypothalamic-pituitary-adrenal axis (HPA axis) function in 30 children with attention-deficit hyperactivity disorder (ADHD) by measuring the diurnal variation and response to the dexamethasone suppression test (DST) of saliva cortisol. Normal diurnal saliva cortisol rhythm was found in only 43.3% of the ADHD children. DST showed suppression in 46.7% of the ADHD children. An abnormal diurnal rhythm and nonsuppression to the DST were more frequent in the severely hyperactive group than in the mildly were more frequent in the severely hyperactive group than in the mildly hyperactive group of children with ADHD. These results suggest abnormalities in HPA axis function in some children with ADHD, especially those exhibiting severe hyperactivity.