Events of children responsible for the development of epilepsy in patients with cerebral palsy

Mohammad Mohsin; Farjana Y. Khan; Ahmed Hosain; Rumi M. Hossain; Nusrat Shams

doi:10.18203/2349-3291.ijcp20242331

Authors

Mohammad Mohsin Department of Pediatrics, Kuwait Bangladesh Friendship Government Hospital, Dhaka, Bangladesh
Farjana Y. Khan Department of Radiology and Imaging, Kurmitola General Hospital, Dhaka, Bangladesh
Ahmed Hosain Department of Paediatric Neurology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
Rumi M. Hossain Department of Paediatric Neurology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
Nusrat Shams Department of Paediatric Neurology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20242331

Keywords:

Cerebral palsy, Epilepsy, Children, Seizure, Epileptiform activity

Abstract

Background: Cerebral palsy (CP) is characterized by abnormal muscle tone, ‘posture, and movement’, thereby limiting the activity of the affected person. Epilepsy is said to occur in 15-90% of children with CP. The aim of this study was to evaluate the events of children responsible for the development of epilepsy considering natal, postnatal characteristics and associated impairment in patients with CP.

Methods: This was a case-control study and was conducted in the Department of Pediatric Neurology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh during the period from January 2020 to December 2020. In total 150 children with cerebral palsy were enrolled in this study who were divided into two groups. In the ‘CP with epilepsy’ group, there were 50 patients, and in the CP without epilepsy group taken as a case group, there were 100 age-sex matched CP patients without epilepsy patients were taken as a control group. Informed written consent was taken from all the parents. Along with baseline characteristics, data regarding natal, postnatal events, general clinical findings, psychological assessment, computed tomography (CT) scan findings of the head, and electroencephalogram (EEG) findings in epilepsy cases were recorded in a predesigned questionnaire and analyzed.

Results: In distributing the CP patients’ comparison regarding postnatal complications neonatal seizures were a strong predictor for epilepsy (p≤0.001). 1^st seizure during 1^st year of life and family history of epilepsy was also a significant event of epilepsy (p≤0.001). In the case of microcephaly, no significant difference was observed between groups (p=0.278). A significant difference was observed when the distribution of severity of intellectual disability of CP patients was compared between groups (p<0.001). Abnormal CT scan findings of the head were significantly higher in CP with epilepsy 42 (84.0%) than in CP without epilepsy 46 (46.0%) (p≤0.001). The total mean age at the onset of epilepsy was 13.58±14.47 months. Epilepsy was most common in spastic quadriplegic CP (54%). 38.0% had focal epileptiform activity on EEG. Clinically focal epilepsy was found in 36.0% of cases.

Conclusions: This study demonstrates the presence of a history of neonatal seizure, 1^st seizure during 1^st year of life, a family history of epilepsy, CT scan abnormalities, severe intellectual disability, and spastic quadriplegic CP were the events responsible for the development of epilepsy in children with CP.

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