Epilepsy Comorbidity in Children with Cerebral Palsy

Image

Cerebral palsy remains as the most frequent cause of motor delay in the young children. Epilepsy can be found in about one-third of childhood patients with cerebral palsy. All seizure types can be seen. Нe most common types are partial complex and secondary generalized seizures. Seizures in children associated with cerebral palsy have the tendency of earlier onset, and harder control, correlated with the severity degree of cerebral palsy and the existence of mental impairment. Нe seizure outcome in patients with cerebral palsy is majorly poor. Нe\ usually require long-term medications and polytherapy, with more chance of intractable seizures and/or status epilepticus. Нe risk of seizure recurrence DÑ–er stopping anticonvulsants in those with cerebral palsy remains high. Factors related to longer seizure-free period in epileptic children having cerebral palsy are normal intelligence quotient, one seizure type, mono-therapy, and spastic diplegic pattern. A recent analysis of seizure types in 166 children with CP due to white matter injury showed the following facts of seizure characteristics: seizures beyond one month of age (25%), West syndrome (2.4%), other epileptic syndromes (8.4%), febrile seizure (7.8%), and benign focal seizures (18%). All of the seizures resolved in 80% patients DÑ–er 2 years. A favorable outcome was demonstrated in this kind of cerebral insult. Another population-based study on neuroimaging pattern in 309 CP children with epilepsy indicated that cerebral mal-development was associated with prepartum antecedents, whereas subcortical/cortical and basal ganglia lesions were associated with intrapartum and postpartum antecedents, suggesting fewer involvements of the white matter injuries in their neuroimaging patterns. In children, the risk factors for seizure recurrence were reported as abnormal electroencephalographic findings epileptic syndrome, serious head injury and CP. In conclusion, many case series and population-based studies have explored epilepsy as a comorbidity of in children with CP. Children with CP have a significant risk of developing epilepsy. Нough there may be a shared neurobiology of epilepsy and CP, further prospective studies to disclose the true association between them are necessary.