Risk Factors For Epilepsy In Children With Cerebral Palsy

Background Cerebral palsy is a major cause of childhood disability and has been described as one of the three most common life-long developmental disabilities in childhood. It is more prevalent in the more socio-economically deprived populations of the world. Epilepsy is said to occur in 15-90% of children with cerebral palsy and this poses additional economic and psychological stress on affected children and their families. Objectives To describe the risk factors for epilepsy in children with cerebral palsy. Methods One hundred and seventy six children with cerebral palsy seen at the Paediatric Neurology clinic, University College Hospital, Ibadan, Nigeria over a period of two years were studied. The group with epilepsy was compared with that without epilepsy. Appropriate statistical tests were carried out using the SPSS 12 for windows software to identify significant predictors of epilepsy. Results Sixty five of the children studied had associated epilepsy, giving a prevalence rate of 36.9%. The significant predictors of epilepsy after adjusting for other variables were seizures in the first year of life and spastic hemiplegia. Neonatal seizures, home delivery and post infectious brain damage which were significantly independently associated with epilepsy were not significant following logistic regression analysis. Conclusion Epilepsy is a frequent problem in children with cerebral palsy. A history of neonatal seizures, occurrence of seizures in the first year of life, presence of spastic hemiplegia and post infectious brain damage all warrant a close evaluation and appropriate follow up for early detection of epilepsy in children with cerebral palsy. Introduction La paralysie cerebrale est une des causes majeures de handicaps chez l\'enfant. Dans le monde entier, elle interesse surtout les couches socio- economiques defavorisees. L\'epilepsie peut survenir chez 90 % des enfants presentant une paralysie cerebrale, entrainant ainsi des contraintes economiques et psychologiques chez des familles deja fort depourvues et eprouvees. L\'objectif est de decrire les facteurs de risque de l\'epilepsie chez les enfants atteints de paralysie cerebrale. Methode 176 enfants avec une paralysie cerebrale ont ete observes a la clinique neurologique pediatrique du centre hospitalier universitaire d\'Ibadan, au Nigeria, sur une periode de 2 ans. Le groupe avec epilepsie a ete compare avec ceux qui n\'etaient pas atteints par cette affection. Des tests statistiques appropries utilisant le SPSS 12 et un logiciel Windows a permis d\'identifier les facteurs predictifs de l\'epilepsie. Resultat 65 des patients etudies, avaient une epilepsie impliquant ainsi un taux de prevalence de 36.9 %. Les facteurs predictifs significatifs d\'epilepsie apres ajustement des zones variables etaient : les crises lors de la premiere annee de la vie et l\'hemiplegie spastique. Les crises neo-natales, l\'accouchement a domicile et les sequelles cerebrales post infectieuses etaient significativement independant de l\'association avec l\'epilepsie. Conclusion L\'epilepsie est un probleme frequent rencontre chez les enfants ayant une paralysie cerebrale. Une histoire clinique de crises neo-natales apparaissant la premiere annee de la vie, la presence d\'une hemiplegie spastique et des dommages cerebraux post infectieux doivent entrainer une detection precoce de l\'epilepsie chez l\'enfant atteint d\'une paralysie cerebrale. Keywords : Africa,Epilepsy, risk factors, cerebral palsy African Journal of Neurological Sciences Vol. 25 (2) 2006: pp. 29-37