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[Clinical analysis of 322 cases of non-epileptic cerebral palsy]

Deng-Na Zhu1, Jun Wang, Yan-Jie Jia

  • 1Department of Neurology, First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China.

Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics
|December 22, 2010
PubMed

Insights

Non-epileptic seizures occur in children with cerebral palsy (CP), with higher frequencies in younger children and those with spastic CP. Differentiating these from epileptic seizures is crucial for accurate diagnosis and management.

Area of Science:

  • Neurology
  • Pediatrics
  • Clinical Neurophysiology

Background:

  • Cerebral palsy (CP) is a common neurodevelopmental disorder in children.
  • Paroxysmal events in children with CP can be challenging to diagnose, with potential for misdiagnosis as epilepsy.
  • Understanding the characteristics of non-epileptic seizures in this population is essential for appropriate care.

Purpose of the Study:

  • To investigate the clinical features of non-epileptic seizures in children diagnosed with cerebral palsy.
  • To determine the prevalence of non-epileptic seizures among children with CP experiencing paroxysmal events.
  • To identify factors associated with non-epileptic seizures in children with CP, including age and type of CP.

Main Methods:

  • A cohort of 1,198 children with CP (aged 9 months to 6 years) was studied.
  • 24-hour video-electroencephalography (VEEG) was used to differentiate epileptic from non-epileptic seizures.
  • Clinical symptoms, age, CP type, and EEG findings were analyzed for children with non-epileptic seizures.

Main Results:

  • Of 1,198 children with CP, 578 (48.24%) had paroxysmal events; 322 (26.88%) were diagnosed with non-epileptic seizures.
  • Common non-epileptic events included tonic seizures, head shaking, shoulder shrugging, crying, panic attacks, sleep myoclonus, and stereotyped movements.
  • Non-epileptic seizures were more frequent in infants (<1 year) and children with spastic CP (52.2%).
  • A significant proportion (34.5%) of children with non-epileptic seizures had nonspecific EEG abnormalities, and 111 (34.5%) were initially misdiagnosed with epilepsy.

Conclusions:

  • Paroxysmal events in children with CP can include non-epileptic seizures, necessitating careful differentiation from epileptic seizures.
  • The occurrence of non-epileptic seizures in children with CP appears to be influenced by the child's age and specific type of CP.
  • Accurate diagnosis is critical to avoid misdiagnosis and ensure appropriate management strategies for children with CP and associated paroxysmal events.
Abstract

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