Evaluation of Risk Factors for Epilepsy in Pediatric Patients with Cerebral Palsy

Sadowska, Małgorzata; Sarecka-Hujar, Beata; Kopyta, Ilona

doi:10.3390/brainsci10080481

Cited by 22 publications

(26 citation statements)

References 47 publications

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“…On the other hand, Baumfeld et al conducted a prospective cohort study and demonstrated that cesarean section was an independent factor affecting neurological disorders in children along with birth weight, maternal age, Apgar score, gestational age and the sex of the neonate [83]. Recent data by Sadowska et al [84] demonstrated that delivery by cesarean section increased the risk of epilepsy over two-fold (OR 2.17) in the patients with cerebral palsy. Deoni et al [111] demonstrated for the first time that caesarean section may be related with changes in brain development, at least during early infancy.…”

Section: Discussionmentioning

confidence: 99%

Pediatrics Consequences of Caesarean Section—A Systematic Review and Meta-Analysis

Słabuszewska-Jóźwiak

Szymański

Ciebiera

et al. 2020

IJERPH

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Background: Cesarean section is a surgical procedure, which is the most frequently performed in gynecology and obstetrics. It is commonly believed that an operative delivery is a less painful and safer mode of delivery, which translates into an increasing number of the procedures performed without medical indications. The maternal sequelae of cesarean sections are well elucidated and widely discussed in the literature, while long-term neonatal consequences still remain the issue of research and scientific dispute. The aim of the present paper was to perform a systematic review of current literature regarding pediatrics consequences of cesarean section. Methods: We reviewed available data from PubMed, Science Direct as well as Google Scholar bases concerning early and long-term neonatal sequelae of operative deliveries. The following key words were used: “cesarean section”, “caesarean section”, “neonatal outcomes”, “respiratory disorders”, “asthma”, “obesity”, “overweight”, and “neurological disorders”. A total of 1636 papers were retrieved out of which 27 were selected for the final systematic review whereas 16 articles provided data for meta-analysis. Statistical analyses were performed using RevMan 5.4. To determine the strength of association between the caesarean section and respiratory tract infections, asthma, diabetes type 1 as well as obesity the pooled odds ratios (OR) with the 95% confidence intervals (CI) were calculated. Results: Conducted meta-analyses revealed that caesarean section is a risk factor for respiratory tract infections (pooled OR = 1.30 95%CI 1.06–1.60, p = 0.001), asthma (pooled OR = 1.23 95%CI 1.14–1.33, p < 0.00001) as well as obesity (pooled OR = 1.35 95%CI 1.29–1.41, p < 0.00001) in offspring. Conclusions: The results of the studies included indicated that children delivered by cesarean section more commonly developed respiratory tract infections, obesity and the manifestations of asthma than children delivered vaginally. The risk of developing diabetes mellitus type 1 or neurological disorders in offspring after caesarean section is still under discussion.

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Section: Discussionmentioning

confidence: 99%

Pediatrics Consequences of Caesarean Section—A Systematic Review and Meta-Analysis

Słabuszewska-Jóźwiak

Szymański

Ciebiera

et al. 2020

IJERPH

Self Cite

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“…As suggested by El-Tallawy et al [ 18 ], neonatal seizures can be a strong predictor of epilepsy in cerebral palsy. Sadowska et al [ 19 ] investigated 181 children with CP and selected 102 children affected by epilepsy (56.35%); among this group, 44 (43%) had drug-resistant epilepsy and only 15 (14.71%) were responsive to treatment. Epilepsy was more frequent in CP children with quadriplegia (75%), ataxia (83%), and mixed forms (80%) in comparison to diplegia (32%) and hemiplegia (38%).…”

Section: Discussionmentioning

confidence: 99%

“…Epilepsy was more frequent in CP children with quadriplegia (75%), ataxia (83%), and mixed forms (80%) in comparison to diplegia (32%) and hemiplegia (38%). Maternal hypertension is considered to be a relevant risk factor for epilepsy in CP children, for which Sadowska et al [ 19 ] reported in their study an odds ratio (OR) of 12.46 ( p = 0.0001), while for drug-resistant epilepsy, they reported an OR of 9.86 ( p = 0.040) [ 19 ]. Other risk factors are represented by delivery by cesarean section, for which the risk of epilepsy in CP children is double (OR = 2.17, p = 0.0129), neonatal seizures with a risk for CP epilepsy calculated as an OR of 3.04 ( p = 0.011), and drug-resistant epilepsy with an OR of 4.02 ( p = 0.002).…”

Section: Discussionmentioning

confidence: 99%

Cerebral Palsy and Epilepsy in Children: Clinical Perspectives on a Common Comorbidity

et al. 2020

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Cerebral palsy (CP) is a frequent cause of childhood disability often associated with a complex group of disorders, including epilepsy, which is reported to impact approximately 40% of affected individuals. This retrospective study involved a group of children affected by CP, some of whom also had comorbid epilepsy. The aim of this study was to report our experience of analyzing, in particular, (a) some of the clinical aspects of the different type of CP, and (b) the relationship between the clinical data of children affected by CP plus epilepsy and each type of CP. Methods: This retrospective single-center study was performed with 93 children admitted to the Pediatric Department of the University of Catania, Italy, affected by CP and distinguished according to the type of motor clinical presentation, with 46 showing epileptic seizures, compared to a control group of 136 children affected by epilepsy without other neurologic disorders. Results: Among the 93 CP children, 25 (27%) had spastic quadriplegia (plus one patient with dystonic quadriplegia), 39 (42%) had spastic hemiplegia, 11 (12%) had spastic diplegia (plus two with ataxia and one with dyskinetic CP), and 14 (15%) did not have a well-defined type of CP. The frequency of epilepsy was higher in affected CP children who showed major motor dysfunction (GMFCS IV–V types). As regards the 46 children with CP plus epilepsy, compared to the group of the control, the age of epilepsy onset was found to be statistically significant: 21 ± 35.1 months vs. 67 ± 39.7. Conclusions: Epilepsy represents one of the most frequent comorbidities of cerebral palsy. In children with CP, particular attention should be paid to the early identification and treatment of comorbid epilepsy.

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“…We excluded epilepsy patients because of the documented multifold risk of unintentional injuries, including injuries causing death among persons with epilepsy in both clinic‐based and population‐based studies 12,13 . Persons with infantile cerebral palsy were excluded because of their severe motor, gait, balance, vestibular, and oculomotor function disruptions, which highly predispose them to injury in addition to high prevalence of epilepsy (>50%) that also predisposes them to injury 14,15 . In addition, we excluded patients with a diagnosis of injury within 1 year prior to the index date ( n = 63,456).…”

Section: Methodsmentioning

confidence: 99%

Increased Risk of Injury Following a Diagnosis of Vertigo: A Population‐based Study

et al. 2021

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Background This study aimed to evaluate whether peripheral vestibular disorders (PVD) are associated with subsequent injury. Methods Data for this follow‐up study were retrieved from the Taiwan's National Health Insurance (NHI) Dataset. A total of 251,355 patients with newly diagnosed PVD during January 2015 to December 2016 was identified as the study cohort, the diagnosis date being their index date. Comparison patients were identified by propensity score‐matching (one per case, n = 251,355 controls) from the remaining NHI beneficiaries in 2015 with their index date being the date of their first health service claim in 2015. We tracked each subject's claims history for 1 year from the index date to identify those who suffered an injury. Cox proportional hazards regressions were performed to calculate the injury hazard ratio of cases versus controls. Results The incidence of injury during 1‐year follow‐up was 128.6 (95% CI = 127.6–129.5) per 1,000 person‐years, 158.2 (95% CI = 156.8–159.6) and 97.5 (95% CI = 96.3–98.7) among the study and comparison cohorts, respectively. After adjusting for demographic variables, the hazard ratio (HR) for injury during 1‐year was 1.663 (95% CI: 1.636–1.690) for cases relative to controls. Conclusions Patients with PVD were at a higher risk for a wide range of injuries, most of all, joint dislocation and sprain. Level of Evidence 3 Laryngoscope, 131:1633–1638, 2021

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Evaluation of Risk Factors for Epilepsy in Pediatric Patients with Cerebral Palsy

Cited by 22 publications

References 47 publications

Pediatrics Consequences of Caesarean Section—A Systematic Review and Meta-Analysis

Pediatrics Consequences of Caesarean Section—A Systematic Review and Meta-Analysis

Cerebral Palsy and Epilepsy in Children: Clinical Perspectives on a Common Comorbidity

Increased Risk of Injury Following a Diagnosis of Vertigo: A Population‐based Study

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