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Epilepsy in children with cerebral palsy
1Department of Pediatrics and Physical Medicine and Rehabilitation, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital and Indian Agricultural Statistics Research Institute, New Delhi, India. gudu@ndf.vanl.net.in
Indian Journal of Pediatrics
|April 4, 2001
Summary
Children with cerebral palsy and epilepsy often have severe, difficult-to-control seizures. Quadriparesis, mental retardation, and myoclonic epilepsy predict a poor response to anti-epileptic drugs (AEDs).
Area of Science:
- Neurology
- Pediatrics
- Epileptology
Background:
- Cerebral palsy (CP) frequently co-occurs with epilepsy, posing significant management challenges.
- Understanding the clinical profile and epilepsy characteristics in children with CP is crucial for optimizing treatment.
Purpose of the Study:
- To investigate the clinical features of children suffering from both cerebral palsy and epilepsy.
- To identify clinical predictors associated with the response to anti-epileptic drugs (AEDs) in this population.
Main Methods:
- A prospective, hospital-based follow-up study included 85 children with CP and epilepsy (excluding neonatal seizures).
- Data collected included seizure classification (ILAE), EEG, neuroimaging, and clinical assessments over a minimum 12-month follow-up.
- Multivariate analysis was employed to determine predictors of AED response.
Main Results:
- Perinatal factors were the primary cause in 72.3% of cases.
- Quadriparesis was the most common motor deficit (64 cases), often associated with mental retardation (80.9%).
- Generalized epilepsy was predominant, particularly in quadriparesis patients who frequently required multiple AEDs. Poor AED response was linked to quadriparesis, microcephaly, mental retardation, and myoclonic epilepsy.
Conclusions:
- Epilepsy in children with cerebral palsy is typically severe and challenging to manage.
- Clinical factors such as quadriparesis, mental retardation, and myoclonic epilepsy are significant predictors of poor response to anti-epileptic drug therapy.