Epilepsy, Cerebral Palsy and Ataxia

*Neurodevelopment and Neurodevelopmental Disorder*

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**48**

Chapter 4

Abstract

epilepticus.

51

1. Introduction

Epilepsy and Cerebral Palsy

Hassan Al Hail, Gayane Melikyan, Naim Haddad,

Osama Alalamy, Covanis Athanasios and Ali A. Asadi-Pooya

Abnormalities of muscle tone, movement, and motor skills are the hallmark of cerebral palsy (CP) which results from injury to the developing brain. Clinically, the syndrome evolves over time and may only be apparent after 3–5 years of age, although suggestive signs and symptoms may be present at an earlier age. Epilepsy is common in CP and occurs in about 30% of patients. Generally, the onset is within the first 2 years of life. Epilepsy is commonly observed in children with spastic hemiplegia, followed by quadriplegia and diplegia. Significant risk factors for the development of epilepsy in patients with CP are family history, neonatal seizure, structural abnormalities, low Apgar scores, and mental retardation. Focal to bilateral tonic-clonic seizures are the most prominent seizure types, followed by focal aware or impaired awareness seizures, while infantile spasms and myoclonic jerks are seen in 25% of cases. Mental retardation is a predisposing factor for early onset of seizures and more severe epilepsy. The overall outcome of seizures in children with CP is generally poor, requiring prolonged course of antiepileptic medication, usually polytherapy with higher incidence of refractory seizures, side effects, comorbidities, and hospital admissions for drug-resistant seizures or status

Keywords: cerebral palsy, epilepsy, seizures, treatment, mental retardation

Cerebral palsy is a term that implies a disorder of motor function. It is a neurodevelopmental abnormality affecting muscle tone, movement, and motor skills. CP is the result of a nonprogressive damage of the nervous system at its early developmental stage and can be caused by several factors encountered in prenatal, perinatal, or postnatal periods [1]. Although the disorder itself is nonprogressive, the clinical expression changes over time as the brain develops and matures.

epilepsy and secondary musculoskeletal complications".

The International Consensus in 2005 defined CP as follows [2]: "CP is a group of permanent neurological disorders resulting from nonprogressive brain injury or malformation that occurred in the developing fetal or infant brain and primarily affecting body movement, posture and muscle coordination. The motor dysfunction in CP is often associated with abnormal cognitive abilities including communication and behavior, disturbance in sensation and perception and last but not least,

Boulenouar Mesraoua, Musab Ali, Dirk Deleu,
