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| 2. |
- Danielsson, Erna, Professor, 1954-, et al.
(författare)
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Krishantering : Central samordning och lokal samverkan
- 2021
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Ingår i: I en tid av pandemi – en ESO-antologi med samhällsvetenskapliga reflektioner. - Stockholm : Expertgruppen för Studier i Offentlig ekonomi (ESO). - 9789152500699 ; , s. 73-86
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Detta kapitel behandlar samverkan under kriser och särskilt hur central samordning och riktlinjer påverkar samverkan på den lokala nivån. Hanteringen av covid19-pandemin analyseras med hjälp av tidigare forskning om samverkan i kriser och exemplifieras med empiriska nedslag.
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| 3. |
- Danielsson, Susanna, 1964
(författare)
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EPILEPSY AND CHILDHOOD AUTISM - with special reference to neuropsychiatric aspects on surgical interventions for medically intractable epilepsy
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Epilepsy is much more common in individuals with autism than in the general population. The extent to which epilepsy influences the outcome of autism is poorly understood. Many children with medically intractable epilepsy have neurodevelopmental disorders, including autism. The objective of this study was to gain further insight into the co-occurrence of epilepsy and autism. In a population-based follow-up study of 120 individuals with autism diagnosed in childhood, 108 were reassessed at ages 17-40 years. The majority had autism and mental retardation (MR). The carers of 42/43 with a history of epilepsy were interviewed, and medical charts were reviewed. Epilepsy onset was most common in the first years of life but also occurred in adults. Partial seizures dominated and seizure frequency had a great impact on the individuals’ lives. Epilepsy remitted in 16%. Severe MR and autism were significantly associated with epilepsy, especially in females. The cognitive level and the adaptive behaviour level were significantly lower in the epilepsy group than in the non-epilepsy group. The medical charts of 16 children undergoing temporal lobe resections were reviewed and the histopathological specimens were re-evaluated. Psychopathology was found in 12. Five had autism before and after surgery, one of whom became seizure free, and in three there was a positive behavioural change. Malformations of cortical development were associated with worse seizure outcome and were more common in children with psychopathology. A neuropsychiatric examination and assessments of psychosocial functioning and IQ were performed at baseline and at 2-year follow-up to assess individual outcome in (i) 25 children undergoing epilepsy surgery, and in (ii) eight children with autism and intractable epilepsy treated with vagus nerve stimulation (VNS). In study (i) psychopathology (mainly autism and ADHD) was present in 17 of the children at some point and contributed in a major way to the psychosocial dysfunction in affected children. Among the children with preoperative psychopathology, one was without a diagnosis after surgery. The IQ level before surgery predicted the IQ level after surgery in most cases. Seven had autism before and after surgery, and the parents reported a positive behavioural change in six. Psychosocial functioning was mainly stable in autism, except in one child who became seizure free and improved in psychosocial functioning and in one child who deteriorated. In study (ii) no one had a reduced seizure frequency after two years of VNS, autism remained and changes concerning intellectual abilities and psychosocial functioning were minor in most subjects. The parents of three children reported a positive change in social interactive abilities, and those of one child reported a negative change. In conclusion, the follow-up study of young adults with autism showed high rates of epilepsy, poor prognosis, and low remission rates. Neuropsychiatric disorders were common at baseline and two years after epilepsy surgery. A diagnosis of autism in children with intractable epilepsy remained after surgical intervention. Symptomatic improvement is not always the same as functional improvement. The main aim of epilepsy surgery is seizure control, regardless of whether or not there is co-existing psychopathology.
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| 4. |
- Danielsson, Susanna, 1964, et al.
(författare)
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Epilepsy in young adults with autism: a prospective population-based follow-up study of 120 individuals diagnosed in childhood.
- 2005
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Ingår i: Epilepsia. - : Wiley. - 0013-9580 .- 1528-1167. ; 46:6, s. 918-923
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Little is known about the long-term outcome of epilepsy in autism and the epilepsy characteristics of adults with autism. This prospective population-based study was conducted in an attempt to point out differences on a group basis between adults with autism with or without epilepsy, and to describe the occurrence, the seizure characteristics, and the outcome of epilepsy in autism. METHODS: One hundred eight of 120 individuals with autism diagnosed in childhood and followed up prospectively for a period of 13-22 years were reevaluated at ages 17-40 years. As adults, the majority had mental retardation and autistic disorder or autistic-like condition. Interviews were performed with the caretakers of 42 of 43 individuals with a history of epilepsy, and their medical records were reviewed. RESULTS: Adults with autism and mental retardation constituted a severely disabled group. On a group basis, both the cognitive level and the adaptive behavior level were lower in the epilepsy group than in the nonepilepsy group (p<0.05). In all, 38% had epilepsy. One third had epilepsy onset before age 2 years. Remission of epilepsy was seen in 16%. Partial seizures with or without secondarily generalized seizures were the dominating seizure type. CONCLUSIONS: In a community sample of individuals with autism followed up from childhood through to adult age, one of three had epilepsy since childhood/adolescence. Severe mental retardation and autism are significantly associated with epilepsy, especially in female patients. Seizure frequency has a great impact on the individuals' lives. Specialist medical care is needed in this severely communication-disabled population.
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| 5. |
- Danielsson, Susanna, 1964, et al.
(författare)
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Lack of effects of vagus nerve stimulation on drug-resistant epilepsy in eight pediatric patients with autism spectrum disorders: a prospective 2-year follow-up study.
- 2008
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Ingår i: Epilepsy & Behavior. - : Elsevier BV. - 1525-5050. ; 12:2, s. 298-304
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Tidskriftsartikel (refereegranskat)abstract
- Vagus nerve stimulation (VNS) therapy has been reported to reduce seizure frequency in some children with drug-resistant epilepsy who are not suitable candidates for epilepsy surgery. It has been suggested that there may be positive cognitive and/or behavioral effects independent of seizure control. We describe the effects of VNS with respect to seizure frequency, cognition, and autistic symptoms and behavior in eight children and adolescents with medically intractable epilepsy and autism. In comparison to baseline, seizure frequency had not decreased in anyone in our series at the 2-year follow-up. In three cases, minor improvements in general functioning were noted, but there were no positive cognitive effects. This open prospective pilot study highlights the need for more prospective studies to prevent false expectations of improvement in this severely disabled group.
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| 6. |
- Danielsson, Susanna, 1964, et al.
(författare)
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Psychopathology, psychosocial functioning, and IQ before and after epilepsy surgery in children with drug-resistant epilepsy.
- 2009
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Ingår i: Epilepsy & Behavior. - : Elsevier BV. - 1525-5050. ; 14:2, s. 330-337
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Tidskriftsartikel (refereegranskat)abstract
- This is a prospective study of a consecutive series of children undergoing epilepsy surgery. The main aims were to evaluate the heterogeneity with respect to psychopathology and IQ, and to use a global assessment scale (Children's Global Assessment Scale [CGAS]) to evaluate psychosocial functioning. Clinical neuropsychiatric and neuropsychological assessments were made at baseline and at the 2-year follow-up in 24 patients, and changes were analyzed at an individual level. Psychiatric disorders (mainly attention deficit hyperactivity disorder and/or autism spectrum disorders) were found in 17 of 24 at some point. All except one child with psychiatric diagnoses before surgery still had at least one diagnosis at follow-up. Intellectual ability remained stable in the majority of cases, both in individuals with and in individuals without mental retardation. The CGAS illustrated the consequences of the extensive comorbidity in this cohort. The behavioral problems had been undiagnosed despite parental concern in many cases, indicating an unrecognized need for services for children with drug-resistant epilepsy.
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| 7. |
- Danielsson, Susanna, 1964, et al.
(författare)
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Temporal Lobe Resections in Children with Epilepsy: Neuropsychiatric Status in Relation to Neuropathology and Seizure Outcome.
- 2002
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Ingår i: Epilepsy & behavior : E&B. - 1525-5069. ; 3:1, s. 76-81
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this work was to relate clinical neuropsychiatric findings to histopathological diagnoses and seizure outcome in a retrospective study of 16 children undergoing temporal lobe resections due to medically intractable epilepsy. These children constitute a heterogeneous group in which neuropsychiatric symptoms were common. The results of this study indicate a correlation between malformations of cortical development, less chance of seizure freedom, and neuropsychiatric problems in children with pharmacoresistant temporal lobe epilepsy. It is important to include neuropsychiatric assessments pre- and postoperatively and to inform parents that symptoms of autism spectrum disorders may or may not be improved after epilepsy surgery.
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| 8. |
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| 9. |
- Johansson, Maria E I, 1961, et al.
(författare)
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Autism spectrum disorder and underlying brain mechanism in the oculoauriculovertebral spectrum.
- 2007
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Ingår i: Developmental Medicine and Child Neurology. - : Wiley. - 0012-1622 .- 1469-8749. ; 49:4, s. 280-288
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Tidskriftsartikel (refereegranskat)abstract
- As part of a multidisciplinary study, the rate of autism spectrum disorder (ASD), learning disability (LD), and brain abnormalities was examined in 20 participants (12 males, 8 females; age range 8mo-17y, mean age 8y 1mo) diagnosed as falling within the oculoauriculovertebral spectrum (OAV). A neuropsychiatric examination was performed, including standardized autism diagnostic interviews. Two individuals met diagnostic criteria for autism, one for autistic-like condition, and five for autistic traits. Four patients had mild LD, three severe LD, two profound LD, and two borderline intellectual functioning. Neuroimaging indicated cerebral abnormalities in more than half of the patients. Abnormalities of white/grey matter were found in more than half of examined individuals; enlargement of ventricles in more than a third. Results indicate that at least a subgroup of ASD may be associated with errors in early embryonic brain development. Awareness of the coexistence of OAV/ASD is important in habilitation care of individuals with OAV.
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| 10. |
- Johansson, Maria E I, 1961, et al.
(författare)
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Autism spectrum disorders and underlying brain pathology in CHARGE association.
- 2006
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Ingår i: Developmental Medicine and Child Neurology. - 0012-1622. ; 48:1, s. 40-50
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Tidskriftsartikel (refereegranskat)abstract
- The rate of autism spectrum disorders (ASDs) and brain abnormalities was analyzed in 31 individuals (15 males, 16 females; age range 1mo to 31y, mean age 8y 11mo) with CHARGE association, as part of a multidisciplinary study. A meticulous neuropsychiatric examination was performed, including standardized autism diagnostic interviews. Judgement regarding ASDs was impossible in three infants and three patients who were deaf and blind. Five individuals met diagnostic criteria for autism, five for an autistic-like condition, and seven for autistic traits. Brain abnormalities were indicated in almost three-quarters of examined individuals, and midline abnormalities of the forebrain in one-third. Awareness of the coexistence of CHARGE and ASDs is important in habilitation care in CHARGE. Moreover, the results indicate that a subgroup of ASDs may be associated with errors in early embryonic brain development.
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