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Growth failure in children with intractable epilepsy is not due to increased resting energy expenditure

A G Christina Bergqvist1, Jillian Trabulsi, Joan I Schall

  • 1Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. bergqvist@email.chop.edu

Developmental Medicine and Child Neurology
|April 22, 2008
PubMed

Insights

Children with intractable epilepsy (IE) have lower resting energy expenditure (REE) and growth status compared to healthy peers. Cerebral palsy (CP) significantly contributes to these differences in children with IE.

Area of Science:

  • Pediatric Neurology
  • Clinical Nutrition
  • Metabolic Research

Background:

  • Intractable epilepsy (IE) can impact a child's overall health and metabolic status.
  • Understanding resting energy expenditure (REE) is crucial for managing nutritional needs in children with chronic conditions.
  • Cerebral palsy (CP) is a common comorbidity in children with IE, potentially affecting their energy balance.

Purpose of the Study:

  • To compare the resting energy expenditure (REE) of children with intractable epilepsy (IE) to that of healthy children.
  • To identify factors, including cerebral palsy (CP), that influence REE patterns in children with IE.
  • To assess growth status and body composition in relation to REE in this population.

Main Methods:

  • Indirect calorimetry was used to measure REE in 25 children with IE and 75 healthy children.
  • Growth parameters (weight z-score, BMI z-score) and body composition (fat-free mass) were assessed.
  • Multiple regression analysis was employed to determine predictors of REE, including CP and energy intake.

Main Results:

  • Children with IE exhibited significantly lower predicted REE, weight z-scores, BMI z-scores, and fat-free mass compared to healthy controls.
  • In children with IE and CP, REE adjusted for body composition was significantly lower (-110 kcal/d).
  • Energy intake was a significant predictor of REE in children with IE.

Conclusions:

  • Cerebral palsy (CP) is a major factor contributing to the reduced growth status and lower REE observed in children with intractable epilepsy (IE).
  • These findings highlight the complex interplay between neurological conditions, comorbidities, and metabolic regulation in pediatric populations.
  • Optimizing nutritional support and considering comorbidities like CP are essential for managing children with IE.

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