Features of epilepsy drug therapy in children with cerebral palsy

Epilepsy often accompanies cerebral palsy (CP). The present study is devoted to the study of the nature of epilepsy and seizures managment in patients with CP. This prospective study was performed with the 160 children with CP admitted to the Children's Neurological Hospital in Baku from 2018 to 2020. Epilepsy affected 110 (68.7%) children with CP. Neonatal seizures (OR=4.4) and maternal infectious diseases during pregnancy (OR=2.6) were identified as a risk factor for the development of epilepsy in patients with CP (p<0.05). The mean age of seizures onset was 16±21.5 months. Among epileptic CP patients, mainly focal 40 (51.3%) and generalized tonic-clonic 22 (28.2%) types of seizures were observed. Seizures occurred significantly more often (55.5%) in children with tetraplegia. Epileptiform activity was recorded in 60 (54.5%) patients, presented mainly with focal epileptiform activity (31.8%). 4 (3.6%) children had normal EEG. Changes during neuroimaging observed in 99 (90%) patients: white matter damage (39.1%), gray matter damage (20.9%) and miscellaneous changes (25,5%). No changes were found in 10% patients. Polytherapy (two antiepileptic drugs or more) was used in 55 (50%) patients; seizure control was achieved in 13.6% of patients. Our study revealed a history of neonatal seizures (OR=12.8; p=0.02) and hemiplegic CP (OR=12.8; p=0.014) as a predictor of polytherapy in patients with CP and epilepsy. Epilepsy in CP is generally poorly treated and often requires multiple anticonvulsants with a high risk of seizure recurrence after drug withdrawal.
Keywords: cerebral palsy; epilepsy; EEG; antiepileptic drugs.