Neuropediatrics 2013; 44 - PS11_1139
DOI: 10.1055/s-0033-1337759

Epilepsy in children with cerebral palsy

T Bildstein 1, M Baumann 1, A Gedik 1, U Albrecht 1, S Baumgartner 1, C Janetschek 2, K Rostásy 1, E Haberlandt 1
  • 1Departement of Pediatrics I, Division of Pediatric Neurology, Medical University Innsbruck, Austria
  • 2Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland

Aims: In a retrospective study (2006 – 2009), cerebral abnormalities shown in the cMRI in children with cerebral palsy (CP) at the University Hospital of Innsbruck in Austria were assigned to a defined lesion pattern, which were correlated to type of seizure, electroencephalographic (EEG) finding, course of epilepsy (EP), and motor impairment.

Methods: The following was the inclusion criteria: younger than 18 years, CP based on the network of the Surveillance of Cerebral Palsy (SCPE), and Epilepsy, regular clinical visits, available EEG and cMRI, as well as EEG and MRI evaluated with a standardized intake form.

Results: A total of 41 children were identified (58% female: n = 24, 42% male: n = 17). Most common subtype of CP was bilateral spastic CP (BS-CP) (59%), followed by unilateral spastic CP (US-CP) (32%), dyskinetic CP (7%), and ataxic CP (2%). Most frequent lesion pattern in the MRI was periventricular leucomalacia (PVL) (34%), followed by complex brain malformation (FB) (27%), cortical-subcortical lesion (CSL) (22%), and basal ganglia lesion (BGL) (17%). A vascular event was found in 49%, whereas cerebral malformations in 27%, and perinatal asphyxia could be detected in 15%. All children with CP (n = 41) had epileptic seizures. In 25of 41 children with CP (61%), partial seizures were dominant, and in 16 of 41 (39%) children, secondary generalized seizures with the clinical presentation of a Lennox-Gastaut syndrome (LGS) were found. Treatment of epilepsy was most difficult in FB (73%), whereas in PVL in 36% and in CSL in 44% patients became seizure free. Patients with BS-CP and dyskinetic CP had the most severe motor impairment, whereas US-CP and ataxic CP caused milder consequences. A significant correlation was noticed between the degree of severity of epilepsy and motor impairment (p < 0.001).

Conclusion: Children with CP have a high risk to develop a difficult to treat epilepsy, which appears to be closely related to the MRI lesional pattern. The aim is to continue this data collection of children with CP and epilepsy to improve the long-term medical care of these patients.