Epilepsy in children with cerebral palsy

Area of Science:

• Pediatric Neurology
• Epileptology
• Developmental Neuroscience

Background:

• Cerebral palsy (CP) is a common neurodevelopmental disorder.
• Epilepsy frequently co-occurs with CP, impacting patient prognosis.
• Understanding the spectrum of epilepsy in CP is crucial for effective management.

Purpose of the Study:

• To delineate the clinical spectrum and prevalence of epilepsy in children with cerebral palsy.
• To investigate factors influencing seizure onset, control, and social quotient in this population.
• To compare social quotient between children with CP and epilepsy versus those with CP alone.

Main Methods:

• Prospective study of 105 children (1-14 years) with CP and active epilepsy.
• Retrospective analysis of 452 CP cases for epilepsy prevalence.
• Utilized electroencephalography (EEG), computed tomography (CT), and Vineland Social Maturity Scale for assessment.
• Included a control group of 60 children with CP but no epilepsy.

Main Results:

• Epilepsy prevalence in CP was 35.4% (160/452).
• Seizure onset occurred before age 1 in 60.95% of cases, with infantile spasms and myoclonic seizures showing significantly earlier onset.
• Seizure control was achieved in 58.1% of children, often requiring polytherapy.
• Abnormalities on EEG (70.5%) and CT (61%) were common.
• Higher social quotient correlated with later seizure onset and better seizure control (P < .01).
• Spastic hemiplegia had the highest epilepsy incidence (66%).

Conclusions:

• Epilepsy is a significant comorbidity in children with cerebral palsy, affecting approximately one-third of cases.
• Epilepsy in CP is frequently severe, with early onset and challenging control, particularly in those with intellectual disability.
• Social quotient is a significant factor influencing seizure control and age of onset in children with CP and epilepsy.