| EPILEPSY
IN CHILDREN WITH CEREBRAL PALSY Epilepsy is a chronic disorder characterized by period episodes of spontaneous brain dysfunction due to excessive energy discharges from brain cells. The clinical manifestations may vary from generalized or local convulsions to momentary spells of impaired consciousness. It has been reported over the years that a “large percentage” of persons with cerebral palsy (CP) also have epilepsy. However, the reports have usually been based on studies of special groups of persons not characteristic of the community (e.g., a hospital series). A recent population-based study has described the frequency and characteristics of epilepsy in 146 children with cerebral palsy born from 1987-1994 in the Goteborg area of Sweden. The findings were: • The frequency of epilepsy in children with cerebral palsy was 38%. • All children with 4-limb CP involvement (“tetraplegia”) and 1/3 of children with other types of CP developed epilepsy. • Children with tetraplegic CP tended to have an onset of epilepsy at an earlier age than children with other types of CP (spastic diplegia; spastic hemiplegia). • Partial seizures (isolated to a specific body part) were the most common seizure type. • CP children with a cognitive impairment (e.g., a learning disability, mental retardation) had a higher frequency of epilepsy. • The study was unable to investigate any genetic factors that may have influence the occurrence of epilepsy associated with cerebral palsy. • The cause of CP may predict the development of epilepsy and the probability of its control: epilepsy occurred more often and seizures were harder to control in children with CP due to brain malformations, brain infections or grey matter damage. epilepsy occurred less often in children with CP due to white matter damage (often associated with prematurity) or due to an unknown cause; also seizure activity was more controllable in these groups.
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