10.1 Incidence of seizures and epilepsy in CP

Epilepsy is highly correlated with CP.

The incidence of epilepsy in CP varies from 33 to 41% [11, 12]. The incidence and type of epilepsy vary according to the type of CP.

The large variation in percentages reported in the literature can be explained in part by the variable length of follow-up periods and the different average age of studied subjects.

Reported rates of seizures and epilepsy in CP vary significantly depending on the underlying pathology and etiology. Epilepsy occurs in 50–94% of children with CP due to diffuse cortical malformations and injuries [17, 18] and in 50% of children with CP secondary to suspected perinatal arterial ischemic stroke [19, 20]. Epilepsy occurs at a much lower frequency (26–43%) in CP and white matter injury (WMI) than in other etiologies [21–24]. The lower frequency of epilepsy and WMI is related to the lack of involvement of cortical gray matter. A recent publication [25] indicated that 25% of children with CP and WMI had seizures beyond the neonatal period with electroclinical features of the agelimited, epileptic syndromes of childhood, with favorable outcome in the majority. Very interesting findings that need to be confirmed, guiding toward better diagnostic, treatment, prognostic, and genetic issues at this early age group.

Seizure onset often occurs in the first 2 years of life. Sixty-one percent of patients with CP had their seizure onset that early. Some reports indicate 36.7% [12] to 69.7% [23] of patients with seizure onset in the first year of life. The onset of epilepsy probably reflects the time of occurrence of brain damage and its severity.

The age of seizure onset also depends on the type of CP. Over 60% of the children with quadriplegia and diplegia have seizures in their first year of life, while 60% of the children with hemiplegia had their first seizure at a later age. Children with myoclonic seizures and infantile spasms had seizure onset very early in life [11].
