BACKGROUND: Paediatric Neurology (PN) is a discipline focused on diagnosis, comprehensive management and research into diseases of the central and peripheral nervous system from fetal life to transition into adulthood. The European Paediatric Neurology Society first designed and published the European PN training programme in the European Paediatric Neurology Syllabus in 2002. This was important in gaining recognition for the sub-specialty from the European Academy of Paediatrics and the European Academy of Neurology and in 2003 PN was recognized as a sub-specialty of paediatrics and neurology by the Board of the European Union of Medical Specialties. In 2004, the EPNS founded the Committee of National Advisors (CNA) that comprised representatives from national Paediatric Neurology societies, in order to further enhance Europe wide standards in training and practice., The EPNS Training Advisory Board (TAB) offers nation specific advice/support to PN societies on developing training and care systems. In 2019, the 2nd revision of the Paediatric Neurology Syllabus was approved by the EPNS Board and CNA. We aim to give an overview of the training of Paediatric Neurology (PN) specialists (i.e. Paediatric Neurologists), the relevant professional bodies and the current practice of Paediatric Neurology in Europe, as defined geographically by the World Health Organization. METHODS: A structured online data collection form was completed by CNA representatives from European countries. The data included training routes and structure of training, epidemiological data, nature of professional societies, organization of Paediatric Neurology care, research, academic life and recognition of the specialty. RESULTS: Data was collected from 43 European countries of which 38 have a national PN Society. In 10 (6 European Union (EU) and 4 non-EU countries) PN is recognized as a core specialty. In 26 countries PN is recognized as a sub-specialty of Paediatrics, Neurology or both (15 EU-11 non-EU). PN is not recognized as a core or sub-specialty in 7 countries (4 EU and 3 non-EU). In 35 countries paediatric neurologists begin their training from Paediatrics, but in 19 countries PN training from Neurology is also possible or the preferred route. Training in PN differs, but in over 50% of countries the three main training modules named in the 2019 2nd revision of the European PN Syllabus (PN, Paediatrics and adult Neurology) are included. Many countries have already adapted their curriculum to the suggestions in the European PN syllabus. CONCLUSIONS: There is diversity among European countries in terms of professional organization and PN training. The European PN syllabus has had impact on the development of PN training throughout Europe, independent of duration of training or route from paediatrics or neurology. The syllabus provides a basis for the future development of PN training, the recognition of PN as a (sub) specialty in individual countries and for improving the care of children with neurological disorders in Europe.

Department of Paediatric Neurology Motol Epilepsy Center 2nd Faculty of Medicine Charles University and Motol University Hospital 5 Úvalu 84 150 06 Prague 5 Czech Republic

Department of Paediatric Neuroscience Addenbrooke's Hospital Cambridge CB2 0QQ United Kingdom

Department of Paediatrics University of Pecs Medical School Jozsef Attila U 7 H 7623 Pecs Hungary

Department of Social Paediatrics Technical University Munich Heiglhofstrasse 65 81377 München Germany

Dept of Paediatric Neurology Erasmus MC Sophia Children's Hospital Dr Molewaterplein 40 3015 GD Rotterdam the Netherlands

Divsion of Pediatric Neurology Development and Rehabilitation Inselspital University Children's Hospital Bern CH 3010 Switzerland

Hacettepe University Faculty of Medicine Department of Paediatrics Division of Paediatric Neurology Ankara Turkey

Helsinki University Hospital and University of Helsinki Children's Hospital Paediatric Neurology Puistosairaala 2 krs Stenbäckinkatu 11 00029 HUS Helsinki Finland

Paediatric Neurology Department University Hospital KULeuven Belgium

Paediatric Neurology Discipline Neuroscience Department Carol Davila University of Medicine and Pharmacy Bucharest Alexandru Obregia Hospital Sos Berceni 10 Sector 4 Bucharest Romania