Characteristics and Challenges of Epilepsy in Children with Cerebral Palsy-A Population-Based Study
Ana Dos Santos Rufino1,2,3, Magnus Påhlman1,4, Ingrid Olsson1,5
1Paediatric Neurology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden.
Insights
Epilepsy affects 43% of children with cerebral palsy (CP), with higher rates in dyskinetic CP. Many children achieved seizure freedom with optimized antiseizure medication (ASM) or surgery, highlighting the need for personalized treatment strategies.
Area of Science:
- Neurology
- Pediatrics
- Public Health
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder.
- Epilepsy frequently co-occurs with CP, impacting patient outcomes.
- Understanding epilepsy characteristics in CP is crucial for effective management.
Purpose of the Study:
- To determine the prevalence and characteristics of epilepsy in children with CP.
- To analyze the relationship between epilepsy and CP type, motor function, and associated impairments.
- To evaluate antiseizure medication (ASM) use and seizure outcomes in this population.
Main Methods:
- Population-based study using data from the CP register of Western Sweden.
- Inclusion of 140 children with CP born between 2003-2006.
- Medical records reviewed at ages 9-12 and 13-16 years for epilepsy diagnosis and treatment.
Main Results:
- 43% of children with CP had epilepsy.
- Epilepsy was more prevalent in dyskinetic CP and associated with neonatal seizures, intellectual disability, motor disability, and autism.
- At 13-16 years, 45% were seizure-free for at least one year; factors like later onset and white matter injury predicted seizure control.
Conclusions:
- Epilepsy is common in children with CP, with specific risk factors and characteristics.
- Optimizing ASM and considering epilepsy surgery are important for seizure control.
- Personalized treatment approaches are essential for managing epilepsy in children with CP.
Abstract:
The aim of this population-based study was to describe the prevalence and characteristics of epilepsy in children with cerebral palsy (CP), focusing on antiseizure medication (ASM) and seizure outcome. Findings were related to CP type, gross motor function and associated impairments. Data on all 140 children with CP born in 2003-2006 were taken from the CP register of Western Sweden. Medical records were reviewed at ages 9-12 and 13-16 years. In total 43% had a diagnosis of epilepsy. Epilepsy was more common in children with dyskinetic CP, who more often had a history of infantile spasms, continuous spike-and-wave during sleep and status epilepticus. Neonatal seizures, severe intellectual disability, severe motor disability and autism were associated with a higher risk of epilepsy. Many children were on polytherapy, and valproate was frequently used, even in girls. At age 13-16 years, 45% of the children with epilepsy were seizure free for at least one year. Onset after 2 years of age, female sex and white matter injury were associated with good seizure outcome. Despite the risk of relapse, reduction or discontinuation of ASM could be an option in selected cases. It is important to optimize ASM and to consider the possibility of epilepsy surgery.
More Related Videos
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:13Seizures: Classification
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types: