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Association of epilepsy with neuroimaging patterns in children with cerebral palsy

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Abstract

Objectives

In this study, we examined whether epilepsy and drug-resistant epilepsy are associated with neuroimaging findings in children with cerebral palsy (CP).

Methods

Magnetic resonance imaging classification system (MRICS) proposed by Surveillance of Cerebral Palsy in Europe (SCPE) was used for classification of different MRI patterns in patients with cerebral palsy. We reviewed the brain MRI scans and medical records of children with CP who were followed-up in our clinic between 2019 and 2023. Patients were divided into three categories: CP without epilepsy, CP with controlled epilepsy and CP with DRE. MRI patterns were grouped as maldevelopments, predominant white matter injury, predominant gray matter injury, miscellaneous (delayed myelination, cerebral atrophy, cerebellar atrophy, brainstem lesions and calcifications, lesions that were not classified under any other group) and normal according to MRICS of the SCPE.

Results

There were 325 CP patients. The most common MRI patterns were predominant white matter injury (47.6%) and gray matter injury (23.8%). There was a 1.5-fold reduction in the risk of epilepsy in patients with predominant white matter injury (OR = 1.54, 95% CI 1.23–1.94). In contrast, children in the miscellaneous group had significantly higher risks of epilepsy (p < 0.001), and we were able to determine that miscellaneous findings increased the risk by 1.8 times (OR = 1.77, 95% CI 1.47–2.12).

Conclusion

In conclusion, more than half of the children with CP had epilepsy, 40.7% of whom had DRE. On MRI, miscellaneous findings may indicate a poor prognosis for epilepsy, while predominant white matter injury may indicate a good outcome. Children with CP, especially those with miscellaneous findings on MRI, should be closely monitored for epilepsy development.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

    Mehmet Akif Kilic, Edibe Pembegul Yildiz, Fulya Kurekci, Ridvan Avci & Hulya Maras Genc

  2. Department of Pediatric Neurology, Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey

    Orhan Coskun

  3. Department of Pediatrics, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey

    Meryem Cura

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  1. Mehmet Akif Kilic
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Kilic, M.A., Yildiz, E.P., Kurekci, F. et al. Association of epilepsy with neuroimaging patterns in children with cerebral palsy. Acta Neurol Belg 124, 567–572 (2024). https://doi.org/10.1007/s13760-023-02385-w

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