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The Profile of Epilepsy and its characteristics in Children with Cerebral Palsy
Archana K1, Lokesh Saini2, Pradeep Kumar Gunasekaran2
1Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 160012.
Insights
Epilepsy affects 26% of children with Cerebral Palsy (CP), with higher incidence in the spastic hemiplegia subtype. Cortical damage severity correlates with epilepsy risk in pediatric CP patients.
Area of Science:
- Pediatric Neurology
- Epileptology
- Developmental Pediatrics
Background:
- Cerebral Palsy (CP) is a common neurodevelopmental disorder.
- Epilepsy frequently co-occurs with CP, impacting patient outcomes.
- Understanding epilepsy characteristics in children with CP is crucial for management.
Purpose of the Study:
- To characterize epilepsy in children with Cerebral Palsy (CP).
- To determine the prevalence and subtypes of epilepsy in pediatric CP patients.
- To investigate the relationship between CP subtype, seizure severity, and functional impairment.
Main Methods:
- Cross-sectional study of 300 children with CP (aged 1-12 years) at a tertiary pediatric hospital.
- Seizure semiologies classified using International League Against Epilepsy (ILAE) criteria.
- Epilepsy severity assessed with the Early Childhood Epilepsy Severity Scale (E-Chess); functional impairment with Gross Motor Function Classification System (GMFCS).
Main Results:
- Epilepsy was present in 26% of children with CP.
- Spastic hemiplegia CP subtype showed the highest seizure incidence (30.4%).
- Most epilepsy cases were drug-responsive (89.9%); GMFCS scores indicated significant motor impairment.
Conclusions:
- Epilepsy prevalence in children with CP is 26%, with spastic hemiplegia being the most affected subtype.
- Increased cortical damage severity is linked to a higher risk of epilepsy.
- CP type, not epilepsy presence, primarily determines Gross Motor Function Classification System (GMFCS) score severity.
Purpose:
To determine the characteristics of epilepsy in children with Cerebral Palsy (CP) visiting the Pediatric Outpatient Department (OPD) of a tertiary care hospital.
Methods:
This cross-sectional study was carried out at a tertiary care pediatric hospital. All children with CP aged between 1 and 12 years seen at this hospital during an 18 months period (January 2018 to July 2019) were included. Children with CP who had seizures were studied in detail. Seizure semiologies were classified according to the International League Against Epilepsy (ILAE) 1981 and 2017 classifications. The severity of seizures was assessed with the Early Childhood Epilepsy Severity Scale (E-Chess). Functional impairment was characterised using the Gross Motor Function Classification System (GMFCS) score.
Results:
Of 300 children with CP, 207 (69%) were male and 93 (31%) female. The mean age was 45.17±31.12 months. Seizures were present in 79 (26%) children. 89.9% of children had drug-responsive epilepsy, and 10.1% had refractory epilepsy. Seizures were present in 30.4% of children with a spastic hemiplegia CP subtype, 28.7% with spastic quadriplegia, 26.3% with spastic diplegia, 24% with mixed type CP, and 6.3% with dyskinetic CP. On E-Chess assessment, the median score was 8 (4-14). The majority had poor Gross Motor Function Classification System (GMFCS) scores (>III).
Conclusion:
The prevalence of epilepsy in the studied population of children with CP was 26%. The highest incidence of seizures was in the spastic hemiplegia subtype (30.4%). The severity of cortical damage is positively correlated with the risk of having epilepsy. The primary determinant of severity of the GMFCS score was the type of CP and not the presence or absence of epilepsy.
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