The prevalence and severity of handicaps in 217 children and adolescents with epilepsy were assessed at the University of Goteborg, Ostra Hospital, Sweden, using the World Health Organization International Classification of Impairments, Disabilities and Handicaps (ICIDH). Major additional disorders occurred in 113 (52%), mental retardation (MR) in 106 and cerebral palsy (CP) in 48 children. Motor and sensory disabilities, involving locomotion, arm and hand function, were common even in children unaffected by CP or MR. Handicap, defined as a disadvantage, resulting from a disability or impairment, adversely affected physical independence and orientation, correlated with epilepsy duration and secondary generalization, and was relieved by epilepsy surgery. 
COMMENT. Children with epilepsy complicated by cerebral palsy or mental retardation are diagnosed and treated early for their associated disabilities and handicaps. Those with epilepsy unassociated with CP or MR frequently have disabilities and handicaps in mobility and physical independence that are often untreated. The prompt recognition and rehabilitation of impairments of coordination, balance, fine motor and sensory function should prevent development of handicap in these patients.
Self-esteem, behavior, and concerns surrounding epilepsy in siblings of children with epilepsy were investigated by the Minnesota Epilepsy Group, St Paul, MN . Families of children with frequent seizures had significantly more stress, but no loss of self-esteem or socialization. The effects of epilepsy on the siblings of children with intractable seizures should receive further study.