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Risk factors for epilepsy in children with cerebral palsy

Nathanel Zelnik1, Muriel Konopnicki, Odeya Bennett-Back

  • 1Department of Pediatrics and the Child Development Center, Carmel Medical Center, Rappaport Faculty of Medicine, 7 Michal Street, 34383 Technion, Haifa, Israel. nzelnik@netvision.net.il

European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society
|July 7, 2009
PubMed

Insights

Neonatal seizures and brain atrophy are key predictors of epilepsy in children with cerebral palsy. Early seizure onset within the first year of life is also common in these children.

Area of Science:

  • Neurology
  • Pediatrics
  • Epileptology

Background:

  • Cerebral palsy (CP) is a common neurodevelopmental disorder.
  • Epilepsy is a frequent comorbidity in children with CP, affecting approximately one-third of cases.
  • Identifying risk factors for epilepsy in CP is crucial for early intervention and management.

Purpose of the Study:

  • To identify predictive risk factors for epilepsy in children diagnosed with cerebral palsy.
  • To compare clinical characteristics of children with CP and epilepsy versus those with CP alone.

Main Methods:

  • Retrospective study analyzing clinical data of children with cerebral palsy.
  • Examined parameters included seizure onset, CP subgroup, epilepsy subtype, neonatal seizures, brain imaging, gestational age, birth weight, delivery mode, Apgar scores, and head size.
  • Statistical analysis to determine significant predictors of epilepsy.

Main Results:

  • Epilepsy was present in 33% of the studied children with cerebral palsy.
  • Neonatal seizures were a strong predictor of epilepsy (p<0.001).
  • Abnormal brain structural findings, particularly brain atrophy, significantly predicted epilepsy (p<0.003).
  • Early seizure onset (within 12 months) was observed in nearly 50% of epileptic children.
  • Low Apgar scores and term birth were more frequent in epileptic children, but not statistically significant after adjustment.

Conclusions:

  • Neonatal seizures and abnormal brain imaging (e.g., atrophy) are significant risk factors for epilepsy in children with cerebral palsy.
  • While early seizure onset is common, factors like mode of delivery, birth weight, and prematurity were not identified as risk factors.
  • Further research into the specific mechanisms linking CP, brain abnormalities, and epilepsy is warranted.

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