Abstract
Cerebral palsy (CP) is a set of etiologically diverse symptoms that change with the child’s age. It is one of the most frequent causes of motor disability in children. CP occurs at a frequency of 1.5 to 3.0 per 1000 live-born children. CP often coexists with epilepsy, which is drug-resistant in a high number of cases. The aim of the present study was to analyze the associations between preconception, prenatal, perinatal, neonatal, and infancy risk factors for epilepsy in a group of pediatric patients with CP. We retrospectively analyzed 181 children with CP (aged 4–17 years at diagnosis), hospitalized at the Department of Pediatrics and Developmental Age Neurology in Katowice in the years 2008–2016. Division into particular types of CP was based on Ingram’s classification. Data were analyzed using STATISTICA 13.0 (STATSOFT; Statistica, Tulsa, OK, USA). Epilepsy was diagnosed in 102 children (56.35%), of whom 44 (43%) had drug-resistant epilepsy; only in 15 cases (14.71%) was epilepsy susceptible to treatment. The incidence of epilepsy varied between the types of CP. It occurred significantly more often in children with tetraplegia (75%), ataxic form (83%), and mixed form (80%) in comparison to diplegia (32%) and hemiplegia (38%). Maternal hypertension was found to be a risk factor for epilepsy in CP patients (OR = 12.46, p < 0.001) as well as for drug-resistant epilepsy (the odds ratio (OR) = 9.86, p = 0.040). Delivery by cesarean section increased the risk of epilepsy in the CP patients over two-fold (OR = 2.17, p = 0.012). We observed also that neonatal convulsions significantly increased the risk for epilepsy (OR = 3.04, p = 0.011) as well as drug-resistant epilepsy (OR = 4.02, p = 0.002). In conclusion, maternal hypertension, neonatal convulsions, and delivery by cesarean section were the most important factors increasing the risk of epilepsy as well as drug-resistant epilepsy in the analyzed group of patients with CP.
Highlights
Cerebral palsy (CP) is a group of permanent, but not unchanging, disorders of movement and/or posture and motor function, which are due to a nonprogressive interference, lesion, or abnormality of the developing/immature brain [1,2,3]
It is accepted that the general incidence of epilepsy in children and adults with CP varies widely between 15% and 55% in selected groups of patients and even reaches 90–94% depending on comorbidities and CP type [10,11,12,13,14,15,16]
The following data were extracted according to the ICD-10 classification; we focused on G80 patients’ records from the hospital data system: data on family history, pregnancy and delivery, types of CP, severity of CP, the level of psychological development, neuroimaging results, data regarding epilepsy
Summary
Cerebral palsy (CP) is a group of permanent, but not unchanging, disorders of movement and/or posture and motor function, which are due to a nonprogressive interference, lesion, or abnormality of the developing/immature brain [1,2,3]. Cerebral palsy occurs at a frequency of 1.5 to 3.0 per 1000 live-born children; these values change among selected groups of patients, depending on various risk factors [4]. It is accepted that the general incidence of epilepsy in children and adults with CP varies widely between 15% and 55% in selected groups of patients and even reaches 90–94% depending on comorbidities and CP type [10,11,12,13,14,15,16]. An analysis of records of 3424 children born between 1976 and 1998 from 17 regions of the Surveillance of Cerebral Palsy in Europe (SCPE) network showed a general incidence of epilepsy of 35% [19]
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