10.6 Seizure control

More than 50% of seizures in patients with CP are fairly controlled. Seizures in patients with hemiplegic CP achieve better control (75%) than those with quadriplegic and diplegic CP (50%); one study reported seizure control in children with CP in nearly two-thirds [4]. Seizure control was achieved with monotherapy in the majority of cases. Polytherapy was required in half, one-third, and one-fourth of cases with diplegic, quadriplegic, and hemiplegic CP, respectively, although this difference did not reach statistical significance. In another study by Hadjipanayis et al., children with spastic hemiplegia (35%) and tetraplegia (28%) were more likely to require polytherapy compared to patients with spastic diplegia (11%) [3]; however, the differences were not statistically significant [3]. Not surprising, polytherapy was required more often in children with infantile spasms and myoclonic seizures. All other seizure characteristics also were more severe in the group requiring polytherapy. In addition, a trend was noted for the following: seizures began earlier, and CT and EEG abnormalities were more often present in children requiring polytherapy.
