Karatoprak Elif, Sözen Gülhan, Saltık Sema
Faculty of Medicine, Department of Pediatric Neurology, Medeniyet University, Istanbul, Turkey.
Department of Pediatric Neurology, Umraniye Training and Research Hospital, Istanbul, Turkey.
Childs Nerv Syst. 2019 Jul;35(7):1181-1187. doi: 10.1007/s00381-019-04152-w. Epub 2019 Apr 22.
Epilepsy is one of the most common and important comorbidity among patients with cerebral palsy (CP). The purpose of this study was to determine the risk factors predicting the development of epilepsy considering prenatal, perinatal, and natal characteristics; associated impairments; and cranial imaging findings in our patient population with cerebral palsy at a tertiary center in Istanbul, Turkey.
This retrospective study consisted of 234 children aged between 3 and 18 years of age. Children were divided into two groups as CP patients with epilepsy (126 patients) and CP patients without epilepsy (108 patients). Demographic features and clinical and cranial magnetic resonance imaging (cMRI) findings were compared between the two groups.
Presence of family history of epilepsy, history of neonatal seizure especially in the first 72 h of life, quadriplegic type of CP, severe degree of gross motor function and fine motor disorders, and moderate to severe mental retardation or psycho-social developmental delay were determined as risk factors for the development of epilepsy in CP patients. Also, an increased risk of epilepsy was detected in term infants and appropriate for gestational age (2500-4000 g) infants. On the other hand, presence of parental consanguinity, being born from a primiparous mother, age of mother at birth, mode of delivery, presence of multiple gestation and labor problems, history of follow-up in neonatal intensive care unit and intubation, and cMRI findings were not significant risk factors for the development of epilepsy in CP.
Predicting epilepsy development by determining the risk factors in patients with CP might be useful because knowing the risk factors could provide close follow-up of these patients for epilepsy.
癫痫是脑瘫（CP）患者中最常见且重要的合并症之一。本研究的目的是确定在土耳其伊斯坦布尔一家三级中心的脑瘫患者群体中，考虑产前、围产期和出生后特征、相关损伤以及头颅影像学检查结果来预测癫痫发生的危险因素。
这项回顾性研究纳入了234名年龄在3至18岁之间的儿童。儿童被分为两组，即患有癫痫的脑瘫患者（126例）和未患癫痫的脑瘫患者（108例）。比较了两组的人口统计学特征、临床和头颅磁共振成像（cMRI）检查结果。
癫痫家族史、新生儿惊厥史尤其是出生后72小时内的惊厥史、四肢瘫型脑瘫、粗大运动功能和精细运动障碍的严重程度以及中度至重度智力发育迟缓或心理社会发育迟缓被确定为脑瘫患者发生癫痫的危险因素。此外，足月儿和适于胎龄（2500 - 4000克）的婴儿发生癫痫的风险增加。另一方面，父母近亲结婚、初产妇分娩、母亲分娩年龄、分娩方式、多胎妊娠和分娩问题、新生儿重症监护病房随访和插管史以及cMRI检查结果并非脑瘫患者发生癫痫的显著危险因素。
通过确定脑瘫患者的危险因素来预测癫痫的发生可能会有所帮助，因为了解这些危险因素可以对这些患者进行密切的癫痫随访。
