| Objective: To explore the clinical features, related factors and prognosis of epilepsy(EP) in children with cerebral palsy(CP).Methods: 1. 255 cases of cerebral palsy cases available in a retrospective analysis from April 2011 to April 2015 admitted to Children’s Hospital Rehabilitation Department at Soochow University. According to whether the merger epilepsy, 255 patients were divided into with cerebral palsy with epilepsy group(MEP,54 cases) and cerebral palsy without epilepsy group(NEP,201 cases). To analysis the incidence, age of onset, childbirth pathological factors, complications, type of cerebral palsy, etc of cerebral palsy with epilepsy. 2. Made a compare of clinical data between the patients with or without epilepsy, to investigate the related factors of cerebral palsy with epilepsy group in children. 3. Following up the prognosis of the cerebral palsy children, 172 children obtained complete information, 35 cases with epilepsy and 137 cases without epilepsy, made a compare of the prognosis between the two groups; then divide the 35 cases into effective and invalid outcome groups according to the prognosis, then made a compare between the two groups to investigate the related factors of invalid outcome of the cerebral palsy children who experienced epilepsy.Results: 1. A total of 255 cases of children with cerebral palsy were collected, cerebral palsy with epilepsy group of 54 cases, the incidence rate was 21.2%; first seizures in children younger than 1 year old accounted for 55.6%; in the main childbirth Pathological factors, asphyxia or HIE 38.9%(21/54), low weight 37.0%(20/54), preterm delivery24.0%(13/54); mental retardation accounted for 87%(47/54); in the main type of cerebral palsy in the MEP group, spastic paralysis accounted for 74.1%(40/54), involuntary movement type 3.7%(3/54), ataxia type 0%(0/54), Spastic quadriplegia which accounted for 33.3%(18/54), followed by hemiplegia 16.7%(9/54), diplegia 13.0%(7/54); Types of seizures, partial seizures accounted for 37.0%(20/54), tonic- clonic made 24.0%(13/54), infantile spasms 16.7%(9/54). 2. The First attack within 1 year of age, history of neonatal seizures, asphyxia or HIE, low birth weight, mental retardation, spastic paralysis(quadriplegia or hemiplegia), imaging showed brain abnormalities, abnormal EEG aspacts had significant difference(P<0.05) between the groups with and without epilepsy, We concluded that the history of neonatal seizures, abnormal EEG were the related factors of cerebral palsy with epilepsy after multivariate Logistic regression analysis. 3. The 1 year old starter, frequent seizures(two times even more epileptic seizures every week), onset duration> 30 minutes, mental retardation, spastic quadriplegia, imaging showed brain abnormalities, EEG shows epileptiform abnormalities had significant difference(P <0.05) between the patients who had epilepsy seizures with effective outcome or invalid outcome. After multivariate Logistic regression analysis, EEG shows epileptiform abnormalities in MEP group was a related factor to poor outcome.Conclusions:1.The incidence of cerebral palsy in children in this study combined epilepsy was 21.2%; The age of onset was mostly below 1 years old; In severe asphyxia or HIE, low birth weight, premature children as the main risk factors; The greatest impact on the level of mental development; Spastic limb paralysis is the most important type of cerebral palsy in children with epilepsy; The occurrence of CP in children with epilepsy is mainly partial seizures.2. History of neonatal seizures, EEG abnormalities were the related factors of cerebral palsy with epilepsy.3. The degree of cerebral palsy and the degree of epilepsy combined with epilepsy have an important influence on the prognosis, EEG abnormalities suggest that the prognosis is poor;On the positive formal rehabilitation training,at the same time, timely and effective control seizures,recovery of children with cerebral palsy motor, cognitive and other functions have a positive effect. |
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