Characteristics and prognosis of epilepsy in children with cerebral palsy.
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J Child Neurol 14 (5): 289--294 (May 1999)

The aims of the study were to describe the prevalence and characteristics of epilepsy in a population of patients with cerebral palsy in a university referral center and to determine the rate of relapse caused by discontinuation of antiepileptic drugs after a 3-year seizure-free period. A total of 178 consecutive patients with cerebral palsy and epilepsy were prospectively followed for 9.2 +/- 2.4 years after onset of seizures and compared to a control group of 150 epileptic patients without cerebral palsy (median follow-up period, 10.5 years). The overall prevalence of epilepsy was 36.1\%. Patients with atonic-diplegic, dystonic, tetraplegic, and hemiplegic cerebral palsy had a higher incidence of epilepsy (87.5\%, 87.1\%, 56.5\%, and 42\%, respectively). In all, 134 (75.3\%) patients were seizure free for more than 3 years and could discontinue therapy, whereas 44 patients (24.7\%) were still on antiepileptic drugs. Eighteen of 134 patients relapsed after a 3-year seizure-free period and subsequent discontinuation of antiepileptic drugs, thus giving a relapse rate of 13.4\%. First seizures occurred during the first year of life in 69.7\% of the patients with epilepsy and cerebral palsy. Complete control of seizures could be achieved in 65.2\% of the patients with cerebral palsy and epilepsy; however, regardless of the prognosis of seizures, epilepsy was a major prognostic factor regarding both the presence of mental retardation and the motor development of children with cerebral palsy.
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