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Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
Published on: September 20, 2024
[Cerebral palsy and epilepsy]
1Institut za zdravstvenu zastitu dece i omladine Vojvodine, Novi Sad. godipo@eunet.yu
Insights
Epilepsy is common in children with cerebral palsy (CP), often presenting early and severely. Management is challenging, with a high risk of refractory seizures and relapse, impacting long-term outcomes.
Area of Science:
- Neurology
- Pediatrics
Context:
- Cerebral palsy (CP) is a leading cause of childhood physical disability.
- Epilepsy frequently co-occurs with CP, presenting unique diagnostic and management challenges.
- Certain epilepsy syndromes are particularly prevalent in children with CP.
Purpose:
- To elucidate the relationship between cerebral palsy and epilepsy.
- To determine the incidence, contributing factors, characteristics, and prognosis of epilepsy in children diagnosed with cerebral palsy.
Summary:
- Epileptic seizures in children with cerebral palsy often manifest earlier and are more severe with greater CP impairment.
- Diagnosis is complicated by communication difficulties and infrequent expert observation.
- Epilepsy in CP frequently requires polytherapy, has a high rate of refractory seizures, and necessitates frequent hospitalizations for status epilepticus.
Impact:
- Epilepsy in children with cerebral palsy has a poor overall prognosis, demanding long-term antiepileptic drug treatment.
- Despite neurological deficits, seizure discontinuation doesn't guarantee a favorable prognosis due to high relapse rates in CP patients.
- Understanding these associations is crucial for improving patient care and therapeutic strategies.
Introduction:
Cerebral palsy is the most common cause of physical disability in early childhood. Epilepsy is known to have a high association with cerebral palsy. All types of epileptic seizures can be seen in patients with cerebral palsy. Complex partial and secondary generalized ones are the most frequent seizure types. In persons with cerebral palsy and mental retardation, the diagnosis of epilepsy presents unique difficulties. Generally they are not able to describe the epileptic events themselves, parents are not able to describe them without fear and persons trained in epilepsy witness the events only rarely. Some syndromes, such as infantile spasms. West and Lennox-Gastaut syndrome, are particularly frequent, whereas children with cerebral palsy are rarely free of epilepsy. It has been observed that epileptic seizures in children with cerebral palsy tend to have an earlier onset; they often appear in children with cerebral palsy and mental retardation; they are more severe in patients with a more severe degree of cerebral palsy. The overall outcome of seizures in children with cerebral palsy is poor, requiring prolonged course of antiepileptic medications, polytherapy with higher incidence of refractory seizures and hospital admissions for status epilepticus. The presence of a neurological deficit, as well as cerebral palsy, does not necessarily mean a poor prognosis after the discontinuation of antiepileptic drugs, but the risk of a relapse in persons with cerebral palsy is high.
Aim:
The objective of the paper was to show the relationship between cerebral palsy and epilepsy and to determine the occurrence, associated factors, nature and prognosis of epilepsy in children with cerebral palsy.
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