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Risk Factors for the Development of Epilepsy Among Children with Cerebral Palsy

Received: 25 March 2023     Accepted: 28 April 2023     Published: 22 August 2023
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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.

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

Keywords

Cerebral Palsy, Epilepsy, Children, Risk Factors

References
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Cite This Article
  • 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

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    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

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    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

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  • @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}
    }
    

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  • 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  - 

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Author Information
  • Department of Pediatrics, Kuwait Bangladesh Friendship Government Hospital, Dhaka, Bangladesh

  • Department of Radiology and Imaging, Kurmitola General Hospital, Dhaka, Bangladesh

  • Department of Pediatrics, Medical College for Women and Hospital, Dhaka, Bangladesh

  • Department of Pediatric Neurology, National Institute of Neurosciences & Hospital, Dhaka, Bangladesh

  • Department of Pediatric Neurology, National Institute of Neurosciences & Hospital, Dhaka, Bangladesh

  • Department of Pediatric Neurology, National Institute of Neurosciences & Hospital, Dhaka, Bangladesh

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