Epilepsy in children with cerebral palsy
- 140 Downloads
This article deals with the clinical profile of children with cerebral palsy and epilepsy, and to study the clinical predictors of response to anti-epileptic drugs. It is a prospective hospital based follow-up study. All the children who presented with cerebral palsy and history of seizure (other than neonatal seizures) over a period of one year were included. Seizures were classified according to ILAE classification. An EEG was obtained in all cases. Neuroimaging was done in all patients. Eighty-five patients were studied and followed for minimum of 12 months. Perinatal factors accounted for 62 (72.3%) cases. The motor deficits seen were quadriparesis (n = 64), hemiplegia (n = 12) and diplegia(n = 9). Associated mental retardation was seen in 80.9% patients with quadriparesis. A predominance of generalised epilepsy was seen with generalised tonic clonic seizures (32.9%) followed by myoclonic seizures(30.6%)and localisation related epilepsy (24.7%). The patients with quadriparesis were more likely to have generalised epilepsy and 52.4% of them required two or more anti-epileptic drugs for control of seizures. Patients with hemiplegia had localisation related epilepsy in 83.3% of cases. On multivariate analysis presence of quadriparesis, microcephaly, mental retardation and myoclonic epilesy were found to predict the poor response to AED. Epilepsy in patients with cerebral palsy is of severe nature and difficult to control. Presence of quadriparesis, mental retardation and myoclonic seizures was predictive of poor response to anti-epileptic drugs.
Key wordsEpilepsy Cerebral palsy EEG
Unable to display preview. Download preview PDF.
- 1.Shapiro BK, Wachtel RC, Palmer FB, Capute AJ. Associated Dysfunction. In Thompson GH, Rubin IL, Bilenker RM, eds.Comprehensive Management of Cerebral Palsy. New York. Grune & Stratton 1983; 87–95.Google Scholar
- 2.Hagberg B, Hagberg G. The origins of cerebral palsy.Recent Advances in Paediatrics 1993; 11: 67–83.Google Scholar
- 3.Commission on classification and terminology of International League against epilepsy. Proposal for revised clinical and electroencephalographic classification of epileptic seizures.Epilepsy 1981; 22: 489–501.Google Scholar
- 9.Agugite U. Tinupen P, Gastaut H. Startle induced epileptic seizures.Epilepsia 1994; 25: 712–720.Google Scholar
- 10.Barkovich JA, Truwit CL. Brain damage from perinatal asphyxia. Correlation of MR findings with gestational age.A J N R 1990; 11: 1087–1096.Google Scholar
- 11.Curatolo P. Epilepsies symptomatic of structural lesions. In Wallace S, Chapman Hall, eds.Epilepsy in Children. London; 1996 : 399–414.Google Scholar
- 13.Delgrado MR, Reila AR, Mills J, Pitt A, Browne R. Discontinuation of antiepileptic drug treatment after two seizure free years in children with cerebral palsy.Pediatrics 1996; 97: 192–197.Google Scholar