Dos Santos Rufino Ana, Påhlman Magnus, Olsson Ingrid, Himmelmann Kate
Paediatric Neurology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, 41685 Gothenburg, Sweden.
Epilepsy Center Frankfurt Rhine-Main, Center of Neurology and Neurosurgery, University Hospital, Goethe-University Frankfurt, 60590 Frankfurt am Main, Germany.
J Clin Med. 2023 Jan 1;12(1):346. doi: 10.3390/jcm12010346.
The aim of this population-based study was to describe the prevalence and characteristics of epilepsy in children with cerebral palsy (CP), focusing on antiseizure medication (ASM) and seizure outcome. Findings were related to CP type, gross motor function and associated impairments. Data on all 140 children with CP born in 2003-2006 were taken from the CP register of Western Sweden. Medical records were reviewed at ages 9-12 and 13-16 years. In total 43% had a diagnosis of epilepsy. Epilepsy was more common in children with dyskinetic CP, who more often had a history of infantile spasms, continuous spike-and-wave during sleep and status epilepticus. Neonatal seizures, severe intellectual disability, severe motor disability and autism were associated with a higher risk of epilepsy. Many children were on polytherapy, and valproate was frequently used, even in girls. At age 13-16 years, 45% of the children with epilepsy were seizure free for at least one year. Onset after 2 years of age, female sex and white matter injury were associated with good seizure outcome. Despite the risk of relapse, reduction or discontinuation of ASM could be an option in selected cases. It is important to optimize ASM and to consider the possibility of epilepsy surgery.
这项基于人群的研究旨在描述脑瘫（CP）患儿癫痫的患病率及特征，重点关注抗癫痫药物（ASM）和癫痫发作结局。研究结果与CP类型、粗大运动功能及相关障碍有关。2003年至2006年出生的所有140例CP患儿的数据取自瑞典西部的CP登记册。在患儿9至12岁以及13至16岁时对其病历进行了回顾。总共有43%的患儿被诊断患有癫痫。癫痫在运动障碍型CP患儿中更为常见，这些患儿更常伴有婴儿痉挛症、睡眠期持续棘慢波和癫痫持续状态病史。新生儿惊厥、严重智力残疾、严重运动残疾和自闭症与癫痫风险较高相关。许多患儿接受联合治疗，丙戊酸盐使用频繁，甚至在女孩中也是如此。在13至16岁时，45%的癫痫患儿至少有一年无癫痫发作。2岁以后发病、女性以及白质损伤与良好的癫痫发作结局相关。尽管有复发风险，但在某些特定情况下，减少或停用ASM可能是一种选择。优化ASM并考虑癫痫手术的可能性很重要。
