Millions of people in the world have cerebral palsy, and more than one-third of these also have epilepsy. The motor disabilities of children with cerebral palsy often are associated with other handicaps, of which epilepsy is among the most common. In addition, the severity of the cerebral palsy correlates directly with the severity of the epilepsy and its eventual control. Nevertheless, for many children with this combined disorder, antiepileptic medication can eventually be discontinued.

The dual handicap of epilepsy and cerebral palsy occurs in 1 in 1,000 live births. When the two disorders coexist, it is reasonable to assume that the etiology also is related—that is, that the same brain injury responsible for causing cerebral palsy also has caused the epilepsy. When a child with cerebral palsy develops epilepsy, only detailed knowledge of the type and etiology of the cerebral palsy and the type of epilepsy can prepare the practitioner to respond properly to parents’ concerns. Unfortunately, this information is lacking in most cases.

Children with cerebral palsy often are multi-handicapped. An association of mental retardation with cerebral palsy is also common in those with epilepsy.

Mental Retardation & CP

Impact on children and their families

Not surprisingly, the impact on the family of a child with epilepsy and cerebral palsy is significant, particularly when the epileptic seizures are uncontrolled. It was studied using a brief questionnaire that measures the impact of neurologic chronic disease in children.38 In families of children with epilepsy only (no behavioral, cognitive, or other neurologic problems), a strong impact was noted only if the children experienced uncontrolled seizures. Otherwise, life was described as fairly normal.

In contrast, for families of children with both epilepsy and neurologic motor deficits, the neurologic deficit had a greater impact on family and on the child’s life in general—whether at home, in school, or with friends and activities—than did epilepsy alone. In fact, problems identified in any of the three domains—behavioral, cognitive, and neurologic—were more influential than were problems related to epilepsy (Camfield, unpublished data).

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The following pages address the pathology of cerebral palsy as it relates to epilepsy, the epidemiology of epilepsy and cerebral palsy, and the association of the two disorders, including the interaction among clinical characteristics, type, and severity of this dual handicap. They also review the prognosis for children with these two disorders: How many become free of seizures and antiepileptic drugs?

Adapted from: Camfield CS, Camfield PR, Watson L. Cerebral palsy in children with epilepsy. In: Devinsky O and Westbrook LE, eds. Epilepsy and Developmental Disabilities. Boston: Butterworth-Heinemann; 2001;33–40. With permission from Elsevier (www.elsevier.com).

Reviewed and revised May 2004 by Steven C. Schachter, MD, epilepsy.com Editorial Board.