EUROPEAN JOURNAL OF PAEDIATRIC NEUROLOGY I4(20I0)67-72 AEDIATRIC ELSEVIER Official Journal of the European Paediatric Neurology Society Original article Risk factors for epilepsy in children with cerebral palsy Nathanel Zelnik", Muriel Konopnicki, Odeya Bennett-Back Tsofia Castel-Deutsch Emmanuel tirosh The Department of Pediatrics and the Child Development Center, Carmel Medical Center, Rappaport Faculty of Medicine, 7 Michal Street, 34383 Technion, Haifa, Israel bThe Child Development Center, Maccabi Healthcare Services, Haifa, Israel The Child Development Center, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel ARTICLE INF O A BSTRACT The purpose of the study was to identify predictive risk factors for epilepsy among children Received 3 October 2008 with cerebral palsy. We conducted a retrospective study of the clinical characteristics of Received in revised form children with cerebral palsy and epilepsy in comparison to those of children with cerebral 29May2009 palsy without epilepsy. The examined parameters included: the prevalence and the age of Accepted 2 June 2009 onset of the seizures, the clinical subgroup of cerebral palsy and subtype of epileptic seizures. We looked for possible risk factors including the presence of neonatal seizures, Keywords: he imaging findings, the gestational age at delivery, the adjusted birth weight, the mod Epilepsy delivery, the Apgar scores, and the head size as well as the presence of consanguinity palsy Epilepsy occurred in 33% of the studied children. Almost 50% of the epileptic children had their first seizure within the first 12 months of life. Neonatal seizures were strong predictors for epilepsy(p<0.001). Presence of at least one abnormal structural finding (particularly brain atrophy) was also a significant predictor of epilepsy(p< 0.003).Low Apgar score at 5 min after birth and birth at term were also found more frequently among patients with epilepsy, although when adjusted with other risk factors, Apgar score did not reach statistical significance. The mode of delivery, head circumference, adjusted birth weight, gender and ethnic group, consanguineous marriage and prematurity were not found to be risk factors for the occurrence of epilepsy in these children. @2009 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved ntroduction epilepsy was found to be neonatal seizures, 25,, but addi tional data regarding birth history parameters that could During the last decade several publications on the clinical increase the risk for the development of epilepsy in these features of children with both epilepsy and cerebral palsy( cp) children were less consistent9-11 In the present retrospective reported the prevalence and the clinical characteristics of multicenter study we further searched for perinatal and early epilepsy in various forms of CP. It has also been consistently infantile predictive factors that could increase the risk of demonstrated that most of these epilepsies occur at an early epileptogenesis in these children age. -6 The most commonly reported risk factor for later Corresponding author. E-mailaddress:zelnik@netvision.net.il(N.Zelnik) 1090-3798/$-see front matter 2009 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved. doi:10.1016/ j.jpn2009.06.002Original article Risk factors for epilepsy in children with cerebral palsy Nathanel Zelnika, *, Muriel Konopnickia , Odeya Bennett-Backa , Tsofia Castel-Deutschb , Emmanuel Tiroshc a The Department of Pediatrics and the Child Development Center, Carmel Medical Center, Rappaport Faculty of Medicine, 7 Michal Street, 34383 Technion, Haifa, Israel b The Child Development Center, Maccabi Healthcare Services, Haifa, Israel c The Child Development Center, Bnai-Zion Medical Center, Rappaport Faculty of Medicine, Technion, Haifa, Israel article info Article history: Received 3 October 2008 Received in revised form 29 May 2009 Accepted 2 June 2009 Keywords: Epilepsy Cerebral palsy abstract The purpose of the study was to identify predictive risk factors for epilepsy among children with cerebral palsy. We conducted a retrospective study of the clinical characteristics of children with cerebral palsy and epilepsy in comparison to those of children with cerebral palsy without epilepsy. The examined parameters included: the prevalence and the age of onset of the seizures, the clinical subgroup of cerebral palsy and subtype of epileptic seizures. We looked for possible risk factors including the presence of neonatal seizures, the imaging findings, the gestational age at delivery, the adjusted birth weight, the mode of delivery, the Apgar scores, and the head size as well as the presence of consanguinity. Epilepsy occurred in 33% of the studied children. Almost 50% of the epileptic children had their first seizure within the first 12 months of life. Neonatal seizures were strong predictors for epilepsy ( p < 0.001). Presence of at least one abnormal structural finding (particularly brain atrophy) was also a significant predictor of epilepsy ( p < 0.003). Low Apgar score at 5 min after birth and birth at term were also found more frequently among patients with epilepsy, although when adjusted with other risk factors, Apgar score did not reach statistical significance. The mode of delivery, head circumference, adjusted birth weight, gender and ethnic group, consanguineous marriage and prematurity were not found to be risk factors for the occurrence of epilepsy in these children. ª 2009 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved. 1. Introduction During the last decade several publications on the clinical features of children with both epilepsy and cerebral palsy (CP) reported the prevalence and the clinical characteristics of epilepsy in various forms of CP. It has also been consistently demonstrated that most of these epilepsies occur at an early age.1–6 The most commonly reported risk factor for later epilepsy was found to be neonatal seizures,2,5,7,8 but addi￾tional data regarding birth history parameters that could increase the risk for the development of epilepsy in these children were less consistent.9–11 In the present retrospective multicenter study we further searched for perinatal and early infantile predictive factors that could increase the risk of epileptogenesis in these children. * Corresponding author. E-mail address: nzelnik@netvision.net.il (N. Zelnik). Official Journal of the European Paediatric Neurology Society 1090-3798/$ – see front matter ª 2009 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.ejpn.2009.06.002 european journal of paediatric neurology 14 (2010) 67–72 第 63 页