Factors affecting epilepsy formation and epilepsy prognosis in cerebral palsy

Material and Method: We enrolled 42 cerebral palsy patients (19 female, 23 male ) in the first group and 56 cerebral palsy patients with epilepsy (23 female, 33 male) in the second group. The mean age of the first group was 7.7±3.3 (minimum 3, maximum 15), and 8.9±3.7 (minimum 3, maximum 16) for the second group. The subjects in the second group were considered to have good prognosis if they were free of seizures for the last year otherwise they were considered to have poor prognosis.Results: In the second group, neonatal epilepsy, family history of epilepsy and moderate to severe mental retardation was significantly higher than the first group (p<0.05). Gender, prematurity, low birth weight, parental consanguinity, etiologic factors, type of cerebral palsy, Palisano scoring, magnetic resonance imaging findings were similiar between the two groups (p>0.05). The onset of seizures was found between 5 months and 13.5 years in the second group (average 3.4±3.6 years). In univariate analysis, neonatal seizure, epileptic activity in electroencephalography, polytherapy was found to be predictors of poor prognosis. Additionally, need for long term medication to control seizures affects prognosis badly. Prematurity, low birth weight, type of cerebral palsy, intelligence quotient, Palisano scoring, magnetic resonance imaging findings, type of seizure, gender and parental consanguinity were not related with prognosis. In logistic regression analysis, neonatal seizure and interictal epileptic activity in electroencephalography were found to be independent predictors of worse outcome. In addition logistic regression analysis revealed that the increasing age decreases the success of epilepsy treatment.In conclusion: Neonatal seizure, family history of epilepsy and mental retardation was found to be important and independent predictors of epilepsy formation in cerebral palsy. Neonatal seizure, interictal epileptic electroensefalogram, polytheraphy and long time to control seizures were independent predictors of poor prognosis for cerebral palsy patients with epilepsy.Key Words: Cerebral palsy, epilepsy, prognosis.