SUMMARY
We have studied 116 patients in Heber's Category VII (encephalopathy due to unknown cause, with neurological signs). 4 of these had a progressive neurological disease of obscure type, 53 had motor disorders, and 59 were epileptic.
19 of the 53 cases of cerebral palsy were also epileptic. In this group, when compared with a control series, the incidence of prematurity, of twins and of neonatal symptoms were increased, suggesting the possible operation of perinatal factors. There was also the usual tendency to a small head (80.6%) with circumferences more than 3 standard deviations below the mean.
In the 59 cases of epilepsy without motor disorders there were 7 cases without overt seizures but an abnormal EEG. In the whole group, the incidence of prematurity and of twins were again raised, and there was also an excess of complications of pregnancy. However, in addition to this evidence that prenatal factors are involved, there was some evidence of genetic factors, for in 10 families there were relatives with epilepsy and/or mental retardation. The tendency to have a small head (27.6%) was less marked than in the cerebral palsy group, but the incidence of psychiatric disorders (64.4%) was high. Among these disorders there were two groups (a) those with hyperactive explosive behaviour, and (b) those who showed psychotic, autistic or withdrawn features. It is considered that brain damage has played a major role in these psychiatric features.