Serebral Palsili Çocuklarda Epilepsinin Klinik Özellikleri ve Olası Risk Faktörleri: Üçüncü Basamak Merkez Deneyimi

Abstract

Amaç: Bu çalışmada serebral palsili (SP) çocuklarda klinik özellikler ile epilepsi gelişiminde olası risk faktörlerinin ve epilepsi prognozunun değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntemler: 2019-2022 yılları arasında SP tanısı ile takip edilen toplam 145 çocuk hasta değerlendirilmiştir. Olguların demografik bilgileri, prenatal/perinatal öyküsü, SP etiyolojisi ve tipi, motor ve bilişsel fonksiyonlardaki bozukluğun derecesi, nöbet tipi, nörogörüntüleme ve elektroensefalografi (EEG) bulguları hastane kayıtlarından retrospektif olarak toplanmıştır. Olgular epilepsisi olan ve epilepsisi olmayan SP hastaları olmak üzere iki gruba ayrılmıştır. Çalışma değişkenleri bu iki grup arasında ve ayrıca dirençli epilepsi ile kontrollü epilepsi grupları arasında karşılaştırılmıştır.

Bulgular: Olguların 91'i (%63) erkek, 54'ü (%37) kız ve ortalama yaşı 11.1±4.2 yıl (3-18 yaş) idi. Toplam 107 (%73.7) olguda epilepsi mevcuttu ve bunların %40.1'i dirençli epilepsi idi. Epilepsi grubunda en sık SP tipi tetraplejik SP idi (p=0.028). Term gebelik, ≥2500 g doğum ağırlığı ve neonatal nöbet öyküsü epilepsili SP grubunda anlamlı olarak daha fazla idi (sırasıyla p=0.03, 0.01 ve 0.03). Dirençli epilepsi grubunda tetraplejik SP tipi (%50) ve ağır zihinsel yetersizlik (%56) görülme oranı kontrollü epilepsi grubuna göre daha yüksekti.

Sonuç: Serebral palsili hastalarda epilepsi gelişiminin öngörülmesinde olası risk faktörlerinin belirlenmesi, yüksek riskli hastaların yakın izlemi açısından önemlidir. Serebral palsili çocuklarda komorbid epilepsinin erken tanımlanması ve tedavisine özellikle dikkat edilmelidir.

Keywords

• serebral palsi
• epilepsi
• risk faktörleri
• dirençli epilepsi
• pediatrik

Clinical Characteristics and Possible Risk Factors of Epilepsy in Children with Cerebral Palsy: A Tertiary-Center Experience

Abstract

Objective: The aim of this study was to evaluate the clinical characteristics of children with cerebral palsy (CP) and to investigate possible risk factors and prognosis of epilepsy in children with cerebral palsy (CP) with a special emphasis on drug-resistant epilepsy (DRE).

Materials and Methods: A total of 145 pediatric patients who were followed up with a diagnosis of CP between 2019 and 2022 were evaluated. Demographic features, prenatal/perinatal history, etiology and type of CP, degree of impairment in motor and cognitive functions, seizure type, neuroimaging, and electroencephalography (EEG) findings were obtained retrospectively from hospital records. The patients were divided into two groups: CP patients with epilepsy and patients without epilepsy. Study variables were compared between these two groups and also between DRE and controlled epilepsy groups.

Results: There were 91 (63%) boys and 54 (37%) girls with a mean age of 11.1 ± 4.2 years (3-18 years). Epilepsy was present in 107 (73.7%) cases and 40.1% of them had refractory epilepsy. Epilepsy was most common in the tetraplegic form of CP (p=0.028). Term gestation, birth weight of ≥2500 g, and history of neonatal seizures were significantly higher in patients with epilepsy (p=0.03, 0.01, and 0.03, respectively). Children with DRE were more likely to have tetraplegic CP (50%) and severe intellectual disability (56%).

Conclusion: Determination of potential risk factors is important in predicting the development of epilepsy in patients with CP, as it may provide closer follow-up of patients at high risk. Particular attention should be paid to the early identification and treatment of comorbid epilepsy in children with CP.

Keywords

• cerebral palsy
• epilepsy
• risk factors
• refractory epilepsy
• pediatric

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