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Epilepsy in children with cerebral palsy: a data linkage study
Aliya Szpindel1, Kenneth A Myers2,3, Pamela Ng3
1Faculty of Medicine, McGill University, Montréal, Quebec, Canada.
Insights
Children with cerebral palsy (CP) have a significantly higher risk of epilepsy than their peers. Those with both CP and epilepsy experience greater healthcare needs, including more frequent and longer hospitalizations.
Area of Science:
- Pediatric Neurology
- Developmental Disabilities
- Public Health
Background:
- Cerebral palsy (CP) is a common childhood motor disability.
- Epilepsy frequently co-occurs with CP, impacting patient outcomes.
- Understanding the prevalence and healthcare needs of children with CP and epilepsy is crucial.
Purpose of the Study:
- To compare epilepsy prevalence in children with CP versus controls.
- To assess healthcare utilization differences in children with CP and epilepsy.
Main Methods:
- Linked Quebec CP registry and administrative health data.
- Defined epilepsy using administrative data algorithms.
- Matched CP registry cohort (n=302) with a control cohort (n=6040).
Main Results:
- Epilepsy prevalence was 42.05% in CP registry cohort and 1.39% in controls.
- Prevalence increased with higher Gross Motor Function Classification System levels.
- Children with CP and epilepsy had more frequent and longer hospitalizations and ED visits.
Conclusions:
- Children with CP have a substantially elevated risk of epilepsy.
- Coexistence of CP and epilepsy signifies a complex subgroup with heightened healthcare demands.
- This highlights the need for integrated care approaches for children with CP and epilepsy.
Aim:
To compare the prevalence of epilepsy in children with cerebral palsy (CP) to peer controls and their differences in healthcare utilization.
Method:
The Quebec CP registry was linked to the provincial administrative health database. Two CP cohorts were identified from the registry (n=302, 168 males, 1y 2mo-14y) and administrative data (n=370, 221 males, 2y 2mo-14y). A control cohort (n=6040, 3340 males, 10-14y) was matched by age, sex, and region to the CP registry cohort. Administrative data algorithms were used to define epilepsy cases. Data on hospitalizations and emergency department presentations were obtained.
Results:
Using the most sensitive epilepsy definition, prevalence was 42.05% in the CP registry, 43.24% in the CP administrative data, and 1.39% in controls. Prevalence rose with increasing Gross Motor Function Classification System level. Children with CP and epilepsy had increased number and length of hospitalizations and emergency department presentations compared to children with CP or epilepsy alone. Epilepsy accounted for approximately 5% of emergency department presentations and 10% of hospitalizations in children with epilepsy, with and without CP.
Interpretation:
Children with CP have an increased risk of epilepsy compared to their peers. Children with CP and coexisting epilepsy represent a unique subset with complex developmental disability and increased healthcare service utilization.
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