Background: Although epilepsy is estimated to exist in ~ 35% of individuals with cerebral palsy (CP), its clinical course within this group is not well defined.
Objective: To determine the clinical characteristics and risk factors associated with refractory epilepsy, in children and adolescents with CP.
Methods: A retrospective chart review of pediatric patients with CP and epilepsy, which were admitted during the years 1998-2018, was performed. Patients with intractable epilepsy vs. those with controlled disease were compared.
Results: A total of 277 medical charts of CP patients were reviewed, out of whom 92 (33%) had epilepsy, from which 20 (21%) was intractable. Independent risk factors of intractability included a younger age of seizure onset (P = .002), presence of brain malformations (P = .003), attending special education systems (P = .004), perinatal distress (P = .03) and a spastic quadriplegia CP type (P = .04). Multivariate analysis demonstrated that refractory epilepsy was associated with a younger age of seizure onset [odds ratio (OR) 4.69, 95% confidence interval (CI), (1.42-11.61, P = .02) and brain malformations (OR 4.16, 95% CI 1.15-7.43, P = .04). A combination of the significant predictive variables for refractory epilepsy yielded an area under the receiver operating curve of 0.873 (0.802–0.943).
Conclusion: We established a predictive model of refractory epilepsy in children and adolescents with CP, composed of five characteristics, which is simple to apply clinically. Early prediction of refractory epilepsy may help in offering alternative therapies, providing better seizure control and quality of life.
