Background: Cerebral palsy is the most common physical disability in children. Epilepsy is one of the most common and important co-morbidity among patients with cerebral palsy. Epilepsy is said to occur in 15–90% of children with CP. There is a paucity of studies among these individuals to determine the risk factors predicting the development of epilepsy. The aim of this study was to determine the risk factors predicting the development of epilepsy considering antenatal, natal, and postnatal characteristics associated impairments and cranial imaging findings in a patient with cerebral palsy. Methods: This case-control study 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 CP with epilepsy, there were 50 patients were taken as the case group, and in CP without epilepsy, there was 100 age- sex-matched patients were taken as a control group. Informed consent was taken from all the parents. Demographic features, clinical findings, functional disability, psychological assessment, computerized tomography (CT) scan, and EEG findings in epilepsy cases were collected in a predesigned questionnaire and analyzed. Results: In this study, 56.0% had age at onset of epileptic seizure less than 12 months. 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%, generalized epilepsy in 32.0%, syndromic epilepsy in 28.0%, and unknown epilepsy in 4.0%. Focal epilepsy is more common in spastic hemiplegia CP. Generalized and syndromic epilepsy is a more common spastic quadriplegic CP. After logistic regression analysis, a significant positive correlation was found between the history of neonatal seizure (OR, 6.769), 1st Seizure during the 1st year of life (OR, 3.660), family history of epilepsy (OR, 16.453), CT scan abnormalities (OR, 4.045), severe intellectual disability (OR, 6.042) and spastic quadriplegic CP (OR, 6.163) with the occurrence of epilepsy in cerebral palsy cases. A statistically significant positive correlation was not found between functional severities of CP by GMFCS, MACS and moderate intellectual disability as a risk factor to develop epilepsy in CP patients. Conclusion: Cerebral palsy is associated with higher incidence of epilepsy. This study determined the presence of history of neonatal seizure, 1st Seizure during the 1st year of life, family history of epilepsy, CT scan abnormalities, severe intellectual disability and spastic quadriplegic CP were the risk factors for the development of epilepsy in children with cerebral palsy.
| Published in | American Journal of Pediatrics (Volume 9, Issue 3) |
| DOI | 10.11648/j.ajp.20230903.19 |
| Page(s) | 154-163 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2023. Published by Science Publishing Group |
Cerebral Palsy, Epilepsy, Children, Risk Factors
| [1] | Donald KA, Kakooza AM, Wammanda RD, Mallewa M, Samia P, Babakir H et al. Pediatriccerebral palsy in Africa: where are we? J of child neurol. 2015; 30 (8): 963-71. |
| [2] | Rosenbaum P, Paneth N, Leviton A, Goldstein M, Martin B. A report: the definition and classification of cerebral palsy. Dev Med Child Neurol. 2007; 49: 8-14. |
| [3] | JrME. Treatment of neuromuscular and musculoskeletal problems in cerebral palsy. Pediatr rehab. 2001; 4 (1): 5-16. |
| [4] | Graham HK, Rosenbaum P, Paneth N. Cerebral palsy. Nat Rev Dis Primers. 2016; 2: 15082. |
| [5] | Tabib SMSB, Khatoon S, Hassan MQ, Baki AE, Rahman AKMF. Prevalence of childhood disabilities and cerebral palsy in the community. In: Banu NA, Shamsad IA, Khan NZ, Haque MM, Ferdous S (editors). First National Conference 2008, March 17-19, Bangladesh society for child neorology, development and disability. Bangladesh College of Physician & Surgeons (BCPS), Mohakha li, Dhaka. |
| [6] | Khandaker G, Muhit M, Karim T, Smithers-Sheedy H, Novak I, Jones C et al. Epidemiology of cerebral palsy in Bangladesh: a population-based surveillance study. Dev Med Child Neurol. 2019; 61 (5): 601-9. |
| [7] | Khandaker G, Smithers-Sheedy H, Islam J, Alam M, Jung J, Novak I et al. Bangladesh Cerebral Palsy Register (BCPR): a pilot study to develop a national cerebral palsy (CP) register with surveillance of children for CP. BMC neurol. 2015; 15 (1): 173. |
| [8] | Gururaj AK, Sztriha L, Bener A, Dawodu A, Eapen V. Epilepsy in children with cerebral palsy. Seizure. 2003; 12: 110–14. |
| [9] | Sellier E, Uldall P, Calado E, Sigurdardottir S, Torrioli MG, Platt MJ et al. Epilepsy and cerebral palsy: characteristics and trends in children born in 1976–1998. EurJPaediatr Neurol. 2012; 16 (1): 48-55. |
| [10] | Kulak W, Sobaniec W. Risk factors and prognosis of epilepsy in children with cerebral palsy in North -Eastern Poland. Brain Dev. 2003; 25 (7): 499–506. |
| [11] | Sun Y, Vestergaard M, Pedersen CB, Christensen J, Olsen J. Apgar scores and long-term risk of epilepsy. Epidemiology. 2006; 17: 296–301. |
| [12] | Krebs L, Langhoff-Roos J. The relation of breech presentation at term to epilepsy in childhood. Eur J Obstet Gynecol Reprod Biol. 2006; 127: 26–28. |
| [13] | Aksu F. Nature and prognosis of seizures in patients with cerebral palsy. Dev Med Child Neurol. 1990; 32 (8): 661-68. |
| [14] | Delgado MR, Riela 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 (2): 192-97. |
| [15] | Karatoprak E, Sözen G, Saltık S. Risk factors associated with epilepsy development in children with cerebral palsy. Child's Nervous System. 2019: 1-7. |
| [16] | Berg AT, Shinnar S, Levy SR, Testa FM. Status epilepticus in children with newly diagnosed epilepsy. Ann Neurol. 1999; 45 (5): 618-23. |
| [17] | Brorson LO, Wranne L. Long-term prognosis in childhood epilepsy: survival and seizure prognosis. Epilepsia. 1987; 28 (4): 324-30. |
| [18] | Cans C, Dolk H, Platt MJ, Colver A, Prasausklene A, Rageloh M. Recommendations from the SCPE collaborative group for defining and classifying cerebral palsy. Dev Med Child Neurol. 2007; 49: 35-38. |
| [19] | Rosenbaum PL, Palisano RJ, Bartlett DJ, Galuppi BE, Russell DJ. Development of the gross motor function classification system for cerebral palsy. Dev Med Child Neurol. 2008; 50 (4): 249-53. |
| [20] | Eliasson AC, Krumlinde-Sundholm L, Rösblad B, Beckung E, Arner M, Öhrvall AM et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol. 2006; 48 (7): 549-54. |
| [21] | Eliasson AC, Ullenhag A, Wahlström U, Krumlinde-Sundholm L. Mini-MACS: Development of the Manual Ability Classification System for children younger than 4 years of age with signs of cerebral palsy. Dev Med Child Neurol. 2017; 59 (1): 72-78. |
| [22] | Reynell J. The Reynell-Zinkin scales: Developmental scales for young visually handicapped children. Windsor. 1979. |
| [23] | Wechsler D. Wechsler Preschool and Primary Scale of Intelligence–third Edition (WPPSI-III). San Antonio, TX: The Psychological Corporation, 2002. |
| [24] | Wechsler D. Wechsler intelligence scale for children–Fourth Edition (WISC-IV). San Antonio, TX: The Psychological Corporation. 2003. |
| [25] | Cooper J. Diagnostic and statistical manual of mental disorders (4th edn, text revision) (DSM–IV–TR) Washington, DC: American Psychiatric Association 2000. 943 pp. £ 39.99 (hb). ISBN 0 89042 025 4. BJPsych. 2001; 179 (1): 85. |
| [26] | Singhi P, Jagirdar S, Khandelwal N, Malhi P. Epilepsy in children with cerebral palsy. J Child Neurol. 2003; 18 (3): 174-79. |
| [27] | Jahan I, Muhit M, Karim T, Smithers-Sheedy H, Novak I, Jones C et al. What makes children with cerebral palsy vulnerable to malnutrition? Findings from the Bangladesh cerebral palsy register (BCPR). Disabil and rehab. 2019; 41 (19): 2247-54. |
| [28] | Mert GG, Incecik F, Altunbasak S, Herguner O, Mert MK, Kiris N et al. Factors affecting epilepsy development and epilepsy prognosis in cerebral palsy. Pediatr neurol. 2011; 45 (2): 89-94. |
| [29] | Zelnik N, Konopnicki M, Bennett-Back O, Castel-Deutsch T, Tirosh E. Risk factors for epilepsy in children with cerebral palsy. Eur J Paediatr neurol. 2010; 14 (1): 67-72. |
| [30] | Bruck I, Antoniuk SA, Spessatto A, Bem RS, Hausberger R, Pacheco CG. Epilepsy in children with cerebral palsy. ArqNeuropsiquiatr. 2001; 59 (1): 35-39. |
| [31] | Kwong KL, Wong SN, So KT. Epilepsy in children with cerebral palsy. Pediatr neurol. 1998; 19 (1): 31-36. |
| [32] | Zafeiriou DI, Kontopoulos EE, Tsikoulas I. Characteristics and prognosis of epilepsy in children with cerebral palsy. J Child Neurol. 1999; 14: 289–94. |
| [33] | El-TallawyHN, Farghaly WM, Shehata GA, Badry R, Rageh TA. Epileptic and cognitive changes in children with cerebral palsy: an Egyptian study. Neuropsych dis and treat. 2014; 10: 971. |
| [34] | Singhi P. The child with cerebral palsy-clinical consideration and management. Indian J Pediatr. 2001; 68: 531-37. |
| [35] | Carlsson M, Hagberg G, Olsson I. Clinical and aetiological aspects of epilepsy in children with cerebral palsy. Dev Med Child Neurol. 2003; 45: 371-76. |
| [36] | Şenbil N, Sonel B, Aydin ÖF, Gürer YK. Epileptic and non-epileptic cerebral palsy: EEG and cranial imaging findings. Brain Dev. 2002; 24 (3): 166-69. |
| [37] | Hanci F, Türay S, Dilek M, Kabakuş N. Epilepsy and drug-resistant epilepsy in children with cerebral palsy: A retrospective observational study. Epilepsy Behav. 2020; 112: 107357. |
| [38] | Hadjipanayis A, Hadjichristodoulou C, Youroukos S. Epilepsy in patients with cerebral palsy. Dev Med Child Neurol. 1997; 39 (10): 659-63. |
| [39] | Fisher RS, Acevedo C, ArzimanoglouA, Bogacz A, Cross JH, Elger CE et al. ILAE official report: a practical clinical definition of epilepsy. Epilepsia. 2014; 55 (4): 475-82. |
| [40] | WallaceSJ. Epilepsy in cerebral palsy. Dev Med Child Neurol. 2001; 43: 713-17. |
APA Style
Mohammad Mohsin, Farjana Yesmin Khan, Razia Sultana, Ahmed Hosain, Nusrat Shams, et al. (2023). Risk Factors for the Development of Epilepsy Among Children with Cerebral Palsy. American Journal of Pediatrics, 9(3), 154-163. https://doi.org/10.11648/j.ajp.20230903.19
ACS Style
Mohammad Mohsin; Farjana Yesmin Khan; Razia Sultana; Ahmed Hosain; Nusrat Shams, et al. Risk Factors for the Development of Epilepsy Among Children with Cerebral Palsy. Am. J. Pediatr. 2023, 9(3), 154-163. doi: 10.11648/j.ajp.20230903.19
AMA Style
Mohammad Mohsin, Farjana Yesmin Khan, Razia Sultana, Ahmed Hosain, Nusrat Shams, et al. Risk Factors for the Development of Epilepsy Among Children with Cerebral Palsy. Am J Pediatr. 2023;9(3):154-163. doi: 10.11648/j.ajp.20230903.19
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ajp.20230903.19,
author = {Mohammad Mohsin and Farjana Yesmin Khan and Razia Sultana and Ahmed Hosain and Nusrat Shams and Seikh Azimul Hoque},
title = {Risk Factors for the Development of Epilepsy Among Children with Cerebral Palsy},
journal = {American Journal of Pediatrics},
volume = {9},
number = {3},
pages = {154-163},
doi = {10.11648/j.ajp.20230903.19},
url = {https://doi.org/10.11648/j.ajp.20230903.19},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20230903.19},
abstract = {Background: Cerebral palsy is the most common physical disability in children. Epilepsy is one of the most common and important co-morbidity among patients with cerebral palsy. Epilepsy is said to occur in 15–90% of children with CP. There is a paucity of studies among these individuals to determine the risk factors predicting the development of epilepsy. The aim of this study was to determine the risk factors predicting the development of epilepsy considering antenatal, natal, and postnatal characteristics associated impairments and cranial imaging findings in a patient with cerebral palsy. Methods: This case-control study 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 CP with epilepsy, there were 50 patients were taken as the case group, and in CP without epilepsy, there was 100 age- sex-matched patients were taken as a control group. Informed consent was taken from all the parents. Demographic features, clinical findings, functional disability, psychological assessment, computerized tomography (CT) scan, and EEG findings in epilepsy cases were collected in a predesigned questionnaire and analyzed. Results: In this study, 56.0% had age at onset of epileptic seizure less than 12 months. 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%, generalized epilepsy in 32.0%, syndromic epilepsy in 28.0%, and unknown epilepsy in 4.0%. Focal epilepsy is more common in spastic hemiplegia CP. Generalized and syndromic epilepsy is a more common spastic quadriplegic CP. After logistic regression analysis, a significant positive correlation was found between the history of neonatal seizure (OR, 6.769), 1st Seizure during the 1st year of life (OR, 3.660), family history of epilepsy (OR, 16.453), CT scan abnormalities (OR, 4.045), severe intellectual disability (OR, 6.042) and spastic quadriplegic CP (OR, 6.163) with the occurrence of epilepsy in cerebral palsy cases. A statistically significant positive correlation was not found between functional severities of CP by GMFCS, MACS and moderate intellectual disability as a risk factor to develop epilepsy in CP patients. Conclusion: Cerebral palsy is associated with higher incidence of epilepsy. This study determined the presence of history of neonatal seizure, 1st Seizure during the 1st year of life, family history of epilepsy, CT scan abnormalities, severe intellectual disability and spastic quadriplegic CP were the risk factors for the development of epilepsy in children with cerebral palsy.},
year = {2023}
}
TY - JOUR T1 - Risk Factors for the Development of Epilepsy Among Children with Cerebral Palsy AU - Mohammad Mohsin AU - Farjana Yesmin Khan AU - Razia Sultana AU - Ahmed Hosain AU - Nusrat Shams AU - Seikh Azimul Hoque Y1 - 2023/08/22 PY - 2023 N1 - https://doi.org/10.11648/j.ajp.20230903.19 DO - 10.11648/j.ajp.20230903.19 T2 - American Journal of Pediatrics JF - American Journal of Pediatrics JO - American Journal of Pediatrics SP - 154 EP - 163 PB - Science Publishing Group SN - 2472-0909 UR - https://doi.org/10.11648/j.ajp.20230903.19 AB - Background: Cerebral palsy is the most common physical disability in children. Epilepsy is one of the most common and important co-morbidity among patients with cerebral palsy. Epilepsy is said to occur in 15–90% of children with CP. There is a paucity of studies among these individuals to determine the risk factors predicting the development of epilepsy. The aim of this study was to determine the risk factors predicting the development of epilepsy considering antenatal, natal, and postnatal characteristics associated impairments and cranial imaging findings in a patient with cerebral palsy. Methods: This case-control study 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 CP with epilepsy, there were 50 patients were taken as the case group, and in CP without epilepsy, there was 100 age- sex-matched patients were taken as a control group. Informed consent was taken from all the parents. Demographic features, clinical findings, functional disability, psychological assessment, computerized tomography (CT) scan, and EEG findings in epilepsy cases were collected in a predesigned questionnaire and analyzed. Results: In this study, 56.0% had age at onset of epileptic seizure less than 12 months. 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%, generalized epilepsy in 32.0%, syndromic epilepsy in 28.0%, and unknown epilepsy in 4.0%. Focal epilepsy is more common in spastic hemiplegia CP. Generalized and syndromic epilepsy is a more common spastic quadriplegic CP. After logistic regression analysis, a significant positive correlation was found between the history of neonatal seizure (OR, 6.769), 1st Seizure during the 1st year of life (OR, 3.660), family history of epilepsy (OR, 16.453), CT scan abnormalities (OR, 4.045), severe intellectual disability (OR, 6.042) and spastic quadriplegic CP (OR, 6.163) with the occurrence of epilepsy in cerebral palsy cases. A statistically significant positive correlation was not found between functional severities of CP by GMFCS, MACS and moderate intellectual disability as a risk factor to develop epilepsy in CP patients. Conclusion: Cerebral palsy is associated with higher incidence of epilepsy. This study determined the presence of history of neonatal seizure, 1st Seizure during the 1st year of life, family history of epilepsy, CT scan abnormalities, severe intellectual disability and spastic quadriplegic CP were the risk factors for the development of epilepsy in children with cerebral palsy. VL - 9 IS - 3 ER -
Email: