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Epilepsy in Children With Cerebral Palsy

Department of Pediatrics, Postgraduate Institute of Medical Education and Research, drsinghi{at}glide.net.in, medinst{at}pgi.chd.nic.in.

Sujeet Jagirdar, MBBS, MD

Department of Pediatrics, Postgraduate Institute of Medical Education and Research

Narendra Khandelwal, MBBS, MD

Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India

Prahbhjot Malhi, MA, PhD

Department of Pediatrics, Postgraduate Institute of Medical Education and Research

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. (J Child Neurol 2003; 18: 174—179).

Journal of Child Neurology, Vol. 18, No. 3, 174-179 (2003)
DOI: 10.1177/08830738030180030601


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