The effect of seizures on functional status of people with spastic forms of cerebral palsy

Background

Cerebral palsy (CP) is the most common childhood motor impairment. Epilepsy affects approximately one third of patients with CP. It is characterized by earlier disclosure, it is more severe and shows greater resistance than that of the general epilepsy treatment, associated with necessity for polytherapy. Its presence can result in gradual loss of function, loss of posture in non-ambulant individuals with severe disabilities and cognitive impairment risk, behavioural disorders and reducing probability of walking.

Aim

The aim of the study was to evaluate the functioning of people with CP with and without epilepsy.

Material and Methods

The study included 210 patients with a diagnosis of CP, aged 0–18 years. The study was conducted among the patients using the physiotherapy services in centres in southern Poland. The study used the Paediatric Evaluation of Disability Inventory (PEDI) and the classification systems: GMFCS, MACS, and CFCS.

Results

There were significant differences with regards to social functioning (53.7/67.4; W = 179, p = 0.006) and support in the social functioning (65.4/89.9; W = 185.5, p = 0.007) in patients with diplegia. However, mobility (19.55/29.00; W = 392, p = 0.018) and the social functioning (36.95/44.1; W = 418.5, p = 0.042) were lower in epileptic patients with tetraplegia. In patients with hemiplegia, there were no significant differences, although each domain with epilepsy subgroup had a lower rating than the subgroup without epilepsy.

Conclusion

The presence of epilepsy is associated with lower levels of social function in patients with cerebral palsy; particularly, with regard to mobility and selfservice.

Assessment of epilepsy impact on the level of social functioning of people with CP (diplegia, tetraplegia, hemiplegia) is difficult because ambiguous relationship with mental retardation. The assessment should be undertaken separately for each group of spastic CP.