Clinical Characteristics and Possible Risk Factors of Epilepsy in Children with Cerebral Palsy: A Tertiary-Center Experience

Abstract
Objective: The aim of this study was to evaluate the clinical characteristics of children with cerebral palsy (CP) and to investigate possible risk factors and prognosis of epilepsy in children with cerebral palsy (CP) with a special emphasis on drug-resistant epilepsy (DRE). Materials and Methods: A total of 145 pediatric patients who were followed up with a diagnosis of CP between 2019 and 2022 were evaluated. Demographic features, prenatal/perinatal history, etiology and type of CP, degree of impairment in motor and cognitive functions, seizure type, neuroimaging, and electroencephalography (EEG) findings were obtained retrospectively from hospital records. The patients were divided into two groups: CP patients with epilepsy and patients without epilepsy. Study variables were compared between these two groups and also between DRE and controlled epilepsy groups. Results: There were 91 (63%) boys and 54 (37%) girls with a mean age of 11.1 ± 4.2 years (3-18 years). Epilepsy was present in 107 (73.7%) cases and 40.1% of them had refractory epilepsy. Epilepsy was most common in the tetraplegic form of CP (p=0.028). Term gestation, birth weight of ≥2500 g, and history of neonatal seizures were significantly higher in patients with epilepsy (p=0.03, 0.01, and 0.03, respectively). Children with DRE were more likely to have tetraplegic CP (50%) and severe intellectual disability (56%). Conclusion: Determination of potential risk factors is important in predicting the development of epilepsy in patients with CP, as it may provide closer follow-up of patients at high risk. Particular attention should be paid to the early identification and treatment of comorbid epilepsy in children with CP.