Progression of motor disability in cerebral palsy: The role of concomitant epilepsy

Purpose: The aim of this study is to investigate the clinical characteristics of epilepsy affecting the progression of motor disabilities in cerebral palsy (CP). Methods: CP patients were retrospectively followed for 15 years from January 2005 to January 2020, and the following items were collected from the medical records: sex, age, etiology, and the clinical features of epilepsy. All patients were divided into two groups of unchanging CP and worsening CP based on whether or not they showed progression of motor disabilities during 15 years' hospitalization, respectively. Results: In total, we evaluated 65 CP cases who had been continuously hospitalized for more than 15 years. Twenty-eight patients had unchanging CP, showing no changes in motor disabilities for 15 years, while 37 had worsening CP, showing a worsening of the motor disabilities over 15 years. Most epilepsy patients with unchanging CP showed their first seizure onset during the first year of life (62.5 %), while the epilepsy patients with worsening CP showed the onset from 1 year of age (70.8 %) (p = 0.03). Daily or weekly seizure frequency was significantly more apparent in cases of worsening CP (25.0 %) than in cases of unchanging CP (p = 0.03). Conclusion: The younger the age at the time of seizure onset, the less severe the consequences appear to be. Furthermore, increased seizure frequency seems to be directly related to reduced functional connections involving the whole brain. These two factors result in progressive motor disabilities, including intellectual, sensory and behavioral difficulties in CP patients.