Epilepsy in children with cerebral palsy

J Child Neurol. 2003 Mar;18(3):174-9. doi: 10.1177/08830738030180030601.

Abstract

To study the spectrum of epilepsy in children with cerebral palsy, 105 consecutive children with cerebral palsy and active epilepsy, between 1 and 14 years of age, were studied prospectively. A detailed history and examination, electroencephalography (EEG), and computed tomography (CT) were done in all cases. The social quotient was assessed using the Vineland Social Maturity Scale. A retrospective cohort of 452 cases of cerebral palsy was studied to find the prevalence of epilepsy in cerebral palsy. A control group of 60 age-matched children with cerebral palsy but no epilepsy was also studied for comparison of the social quotient. Of the 105 children, 65 were male, 40 of 105 (38%) had a history of birth asphyxia. The mean age of onset of seizures was 18.9 months; 64 (60.95%) had seizure onset before 1 year of age. Children with myoclonic seizures (P < .05) and infantile spasms (P < .01) had seizure onset significantly early in life. Generalized seizures were the most common, followed by partial seizures, infantile spasms, and other myoclonic seizures. Seizures were controlled in 45 (58.1%) children, and polytherapy was required in 40 children. EEG and CT abnormalities were seen in 70.5% and 61% of the children. Seizure control was achieved in 74% of the patients with a normal to borderline social quotient compared with 48.7% with a social quotient less than 70. Social quotient values had a positive correlation with age of onset of seizures (P < .01) and with better control of seizures (P < .01). Of the cohort of 452 children, 160 (35.4%) had epilepsy. The maximum incidence (66%) was seen in children with spastic hemiplegia, followed by quadriplegia (42.6%) and diplegia (15.8%). Epilepsy in cerebral palsy is seen in about one third of cases; it is often severe and difficult to control particularly in children with mental retardation.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Age of Onset
  • Anticonvulsants / therapeutic use
  • Cerebral Palsy / complications
  • Cerebral Palsy / physiopathology*
  • Child
  • Child, Preschool
  • Cohort Studies
  • Electroencephalography
  • Epilepsy / epidemiology*
  • Epilepsy / etiology
  • Epilepsy / physiopathology*
  • Female
  • Humans
  • Infant
  • Intellectual Disability / physiopathology
  • Male
  • Retrospective Studies
  • Seizures / physiopathology
  • Tomography, X-Ray Computed

Substances

  • Anticonvulsants