Epilepsy among Cerebral Palsy Children: Clinical Predictors and Frequency

Introduction: Epilepsy is one of the most common neurological disorder in childhood. The risk of epilepsy is highest in children with brain abnormalities, such as cerebral palsy. There are a lot of studies showing that epilepsy varies from 12-19 percent in children with CP.

Objective: The objective of this study is to determine the relationship between cerebral palsy (CP) and epilepsy and how to predict development of seizures among cerebral palsy children.

Subject and Methods: A prospective study included 82 patients with cerebral palsy and history of seizure. Seizure were classified according to ILAE classification, an EEG and neuro-imaging were obtained in all cases. We analyzed the incidence of different types of epilepsy in relation to different subtypes of cerebral palsy. Other factors associated with epilepsy such as age of starting first attack, neonatal seizures and familial factors were also analyzed.

Results: In our study the most common risk factors were perinatal factors 40 patients (48.8%): 16 of them had epilepsy. While the less common risk factors were postnatal factors 10 patients (12.2%): 6 of them had epilepsy. The incidence of epilepsy in our sample was significantly higher with very sever types of CP affecting 58.8% of very sever CP (P = 0.007). In contrary the mild type of CP was significantly associated with 3% only of the prevalence of epilepsy (P = 0.05). Abnormal CT brain findings were found in only 19 (39.6%) patients and there was no abnormality in CT brain in 29(60.4%) patients. High prevalence of epilepsy was associated with neonatal seizures and positive family history of epilepsy (p<0.005).

Conclusions: Epilepsy among children with CP is common and the most common risk factors were perinatal factors. The predominant form of epilepsy was generalized. Brain CT imaging allowed definition of extent of associated brain damage and mostly significant frequency of abnormal findings were detected in epileptic CP children.