Epilepsy in Children With Cerebral Palsy

Cerebral palsy is a group of disorders that are usually caused by some amount of injury to the brain or head before, during, or shortly after birth. Since the disorder is caused in this manner, many people with cerebral palsy suffer from seizures as well. In the traditional sense, cerebral palsy is not a seizure disorder like epilepsy. Cerebral palsy may be mistaken for such a seizure disorder, but cerebral palsy is a non-progressive group of disorders. Thus, the symptoms of cerebral palsy do not get worse or better over time.

Seizures in cerebral palsy and other seizure disorders take place when there is some overactivity or misdirected activity of electricity in the brain. People with cerebral palsy can later also develop some forms of epilepsy. These people who develop the seizure disorder epilepsy, and have cerebral palsy, usually have a much more variable rate of exhibiting symptoms.


Two types of seizures that are common in people with cerebral palsy are the tonic-clonic (or “grand mal”) seizure and the partial seizure. Both types of seizures can be very disconcerting both for the person who has them and their family members. These seizure disorder symptoms can be especially troubling in children.
Spastic tetraplegia was the commonest type of CP associated with seizures whereas spastic diplegia was the commonest variety of CP in group 2. Most children with CP had an early onset of seizures within the first year of life as against those without CP. The children in group 1 had a higher incidence of neonatal seizures (42.9% vs. 29.4% in group 2 and 0% in group 3), presence of significant developmental delay (98.2% vs. 20.0% in group 3), occurrence of significant abnormalities on brain imaging (94.6% vs. 19.6% in group 3) and a need for use of more than 1 antiepileptic drug (66.1% vs. 30.0% in group 3). Over half of children in the study group presented with generalized tonic clonic seizures; the electroencephalogram (EEG) showed focal epileptic discharges with or without secondary generalization in 39.3%. The overall outcome of seizures in children with CP was poor needing prolonged course of anticonvulsant medications, polytherapy and higher incidence of refractory seizures and admissions for status epilepticus compared to the control group.
Cerebral palsy is associated with a higher incidence of seizure disorders, which, in a majority, has its onset in the neonatal period; brain imaging showed abnormal pathology in most affected children, which possibly accounts for the tendency to more refractory seizures in these children.