Skip to main content
SpringerLink
Log in

Prevalence and demographic characteristics of comorbid epilepsy in children and adolescents with cerebral palsy: a nationwide population-based study

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Introduction

The nationwide prevalence of cerebral palsy (CP) is unknown due to the lack of a population-based registration system for CP in Taiwan. This study was the largest nationwide, population-based, cross-sectional study to estimate the prevalence of CP, prevalence rates of comorbid epilepsy in patients with CP, and association with socioeconomic status (SES) in Taiwan. The crude prevalence rate and age- and gender-specific prevalence rates were estimated.

Methods

A total of 8419 patients with CP were enrolled, and the estimated prevalence of CP was 1.76‰ in the pediatric population and 1.51‰ and 1.98‰ in girls and boys, respectively. The prevalence rate of epilepsy in patients with CP was 29.8%.

Results

The result revealed a higher prevalence of CP and epileptic CP in members of families with lower insurance premiums than those with higher insurance premiums and those from East Taiwan compared with those from other areas of Taiwan. Moreover, a higher prevalence of CP is shown in rural area than urban area.

Discussion

SES and geographic variables were significantly associated with the risk of epilepsy in children with CP. Patients with epileptic CP had a higher odds ratio of several neuropsychiatric diseases, including mental retardation, ophthalmologic problems, hearing impairment, and hydrocephalus.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Fan HC, Ho LI, Chi CS, Cheng SN, Juan CJ, Chiang KL, Lin SZ, Harn HJ (2015) Current proceedings of cerebral palsy. Cell Transplant 24:471–485

    Article  PubMed  Google Scholar 

  2. Wallace SJ (2001) Epilepsy in cerebral palsy. Dev Med Child Neurol 43:713–717

    Article  CAS  PubMed  Google Scholar 

  3. Bruck I, Antoniuk SA, Spessatto A, Bem RS, Hausberger R, Pacheco CG (2001) Epilepsy in children with cerebral palsy. Arq Neuropsiquiatr 59:35–39

    Article  CAS  PubMed  Google Scholar 

  4. Zelnik N, Konopnicki M, Bennett-Back O, Castel-Deutsch T, Tirosh E (2010) Risk factors for epilepsy in children with cerebral palsy. European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society 14:67–72

    Article  Google Scholar 

  5. Hadjipanayis A, Hadjichristodoulou C, Youroukos S (1997) Epilepsy in patients with cerebral palsy. Dev Med Child Neurol 39:659–663

    Article  CAS  PubMed  Google Scholar 

  6. Singhi P, Jagirdar S, Khandelwal N, Malhi P (2003) Epilepsy in children with cerebral palsy. J Child Neurol 18:174–179

    Article  PubMed  Google Scholar 

  7. Kulak W, Sobaniec W (2003) Risk factors and prognosis of epilepsy in children with cerebral palsy in north-eastern Poland. Brain Dev 25:499–506

    Article  PubMed  Google Scholar 

  8. Gururaj AK, Sztriha L, Bener A, Dawodu A, Eapen V (2003) Epilepsy in children with cerebral palsy. Seizure J British Epilepsy Assoc 12:110–114

    Article  CAS  Google Scholar 

  9. Carlsson M, Hagberg G, Olsson I (2003) Clinical and aetiological aspects of epilepsy in children with cerebral palsy. Dev Med Child Neurol 45:371–376

    Article  PubMed  Google Scholar 

  10. Sellier E, Uldall P, Calado E, Sigurdardottir S, Torrioli MG, Platt MJ, Cans C (2012) Epilepsy and cerebral palsy: characteristics and trends in children born in 1976-1998. European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society 16:48–55

    Article  Google Scholar 

  11. Chiang KL, Cheng CY (2014) Prevalence and neuro-psychiatric comorbidities of pediatric epilepsy in Taiwan: a national population-based study. Epilepsy Res 108:1451–1460

    Article  PubMed  Google Scholar 

  12. Okumura A, Hayakawa F, Kato T, Kuno K, Watanabe K (1999) Epilepsy in patients with spastic cerebral palsy: correlation with MRI findings at 5 years of age. Brain Dev 21:540–543

    Article  CAS  PubMed  Google Scholar 

  13. El-Tallawy HN, Farghaly WM, Shehata GA, Badry R, Rageh TA (2014) Epileptic and cognitive changes in children with cerebral palsy: an Egyptian study. Neuropsychiatr Dis Treat 10:971–975

    PubMed  PubMed Central  Google Scholar 

  14. Kwong KL, Wong SN, So KT (1998) Epilepsy in children with cerebral palsy. Pediatr Neurol 19:31–36

    Article  CAS  PubMed  Google Scholar 

  15. Chien IC, Lin CH, Chou YJ, Chou P (2012) Prevalence, incidence, and stimulant use of attention-deficit hyperactivity disorder in Taiwan, 1996–2005: a national population-based study. Psychiatry Psychiatr Epidemiol 47:1885–1990

    Article  Google Scholar 

  16. Kuo RN, Lai MS (2013) The influence of socio-economic status and multimorbidity patterns on healthcare costs: a six-year follow-up under a universal healthcare system. Int J Equity Health 12:69

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chien LC, Wu JC, Chen YC, Liu L, Huang WC, Chen TJ, Thien PF, Lo SS, Cheng H (2012) Age, sex, and socio-economic status affect the incidence of pediatric spinal cord injury: an eleven-year national cohort study. PLoS One 7:e39264

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Chen CC, Chen LS, Yen MF, Chen HH, Liou HH (2012) Geographic variation in the age- and gender-specific prevalence and incidence of epilepsy: analysis of Taiwanese National Health Insurance-based data. Epilepsia 53:283–290

    Article  PubMed  Google Scholar 

  19. Liu C-Y, Hung Y, Chuang Y, Chen Y, Weng W, Liu J, Liang K (2006) Incorporating development stratification of Taiwan townships into sampling design of large scale health interview survey. J Health Manag 4:1–22

    CAS  Google Scholar 

  20. Lin Y-H, Tseng Y-H, Chen Y-C, Lin M-H, Chou L-F, Chen T-J, Hwang S-J (2013) The rural-urban divide in ambulatory care of gastrointestinal diseases in Taiwan. BMC Int Health Hum Rights 13:15

    Article  PubMed  PubMed Central  Google Scholar 

  21. Winter S, Autry A, Boyle C, Yeargin-Allsopp M (2002) Trends in the prevalence of cerebral palsy in a population-based study. Pediatrics 110:1220–1225

    Article  PubMed  Google Scholar 

  22. Arneson CL, Durkin MS, Benedict RE, Kirby RS, Yeargin-Allsopp M, Van Naarden BK, Doernberg NS (2009) Prevalence of cerebral palsy: Autism and Developmental Disabilities Monitoring Network, three sites, United States, 2004. Disability Health J 2:45–48

    Article  Google Scholar 

  23. Paneth N, Hong T, Korzeniewski S (2006) The descriptive epidemiology of cerebral palsy. Clin Perinatol 33:251–267

    Article  PubMed  Google Scholar 

  24. Ashwal S, Russman BS, Blasco PA, Miller G, Sandler A, Shevell M, Stevenson R (2004) Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology 62:851–863

    Article  CAS  PubMed  Google Scholar 

  25. (2000) Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Surveillance of Cerebral Palsy in Europe (SCPE). Developmental Medicine Child Neurology 42: 816–824

  26. Reid SM, Carlin JB, Reddihough DS (2011) Rates of cerebral palsy in Victoria, Australia, 1970 to 2004: has there been a change? Dev Med Child Neurol 53:907–912

    Article  PubMed  Google Scholar 

  27. Toyokawa S, Maeda E, Kobayashi Y (2017) Estimation of the number of children with cerebral palsy using nationwide health insurance claims data in Japan. Dev Med Child Neurol 59:317–321

    Article  PubMed  Google Scholar 

  28. Park MS, Kim SJ, Chung CY, Kwon DG, Choi IH, Lee KM (2011) Prevalence and lifetime healthcare cost of cerebral palsy in South Korea. Health Policy 100:234–238

    Article  PubMed  Google Scholar 

  29. He P, Chen G, Wang Z, Guo C, Zheng X (2017) Children with motor impairment related to cerebral palsy: prevalence, severity and concurrent impairments in China. J Paediatr Child Health 53:480–484

    Article  Google Scholar 

  30. Nissen S, Purssell E, Shaw K, Bailey C, Efstathiou N, Dunford C (2017) Impaired mobility associated with an increased likelihood of death in children: a systematic review. Journal of child health care : for professionals working with children in the hospital and community: 1367493517732839

  31. Strauss D, Brooks J, Rosenbloom L, Shavelle R (2008) Life expectancy in cerebral palsy: an update. Dev Med Child Neurol 50:487–493

    Article  PubMed  Google Scholar 

  32. Solaski M, Majnemer A, Oskoui M (2014) Contribution of socio-economic status on the prevalence of cerebral palsy: a systematic search and review. Dev Med Child Neurol 56:1043–1051

    Article  PubMed  Google Scholar 

  33. Oskoui M, Coutinho F, Dykeman J, Jette N, Pringsheim T (2013) An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol 55:509–519

    Article  PubMed  Google Scholar 

  34. Dolk H, Pattenden S, Johnson A (2001) Cerebral palsy, low birthweight and socio-economic deprivation: inequalities in a major cause of childhood disability. Paediatr Perinat Epidemiol 15:359–363

    Article  CAS  PubMed  Google Scholar 

  35. Hemming K, Hutton JL, Colver A, Platt MJ (2005) Regional variation in survival of people with cerebral palsy in the United Kingdom. Pediatrics 116:1383–1390

    Article  PubMed  Google Scholar 

  36. King G, Imms C, Palisano R, Majnemer A, Chiarello L, Orlin M, Law M, Avery L (2013) Geographical patterns in the recreation and leisure participation of children and youth with cerebral palsy: a CAPE international collaborative network study. Developmental neurorehabilitation 16:196–206

    Article  PubMed  Google Scholar 

  37. Wang CM, Chen CY, Leong CP, Wong MK (1992) Cerebral palsy investigation in South Taiwan. J Rehabilitation Med Republic China 20:113–117

    Google Scholar 

  38. Aisen ML, Kerkovich D, Mast J, Mulroy S, Wren TA, Kay RM, Rethlefsen SA (2011) Cerebral palsy: clinical care and neurological rehabilitation. Lancet Neurol 10:844–852

    Article  PubMed  Google Scholar 

  39. Bottcher L (2010) Children with spastic cerebral palsy, their cognitive functioning, and social participation: a review. Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence 16:209–228

    Article  Google Scholar 

  40. Song CS (2013) Relationships between physical and cognitive functioning and activities of daily living in children with cerebral palsy. J Phys Ther Sci 25:619–622

    Article  PubMed  PubMed Central  Google Scholar 

  41. Odding E, Roebroeck ME, Stam HJ (2006) The epidemiology of cerebral palsy: incidence, impairments and risk factors. Disabil Rehabil 28:183–191

    Article  PubMed  Google Scholar 

  42. Van Hus JW, Potharst ES, Jeukens-Visser M, Kok JH, Van Wassenaer-Leemhuis AG (2014) Motor impairment in very preterm-born children: links with other developmental deficits at 5 years of age. Dev Med Child Neurol 56:587–594

    Article  PubMed  Google Scholar 

  43. Yim SY, Yang CY, Park JH, Kim MY, Shin YB, Kang EY, Lee ZI, Kwon BS, Chang JC, Kim SW, Kim MO, Kwon JY, Jung HY, Sung IY (2017) Korean database of cerebral palsy: a report on characteristics of cerebral palsy in South Korea. Annals of rehabilitation medicine 41:638–649

    Article  PubMed  PubMed Central  Google Scholar 

  44. Minocha P, Sitaraman S, Sachdeva P (2017) Clinical spectrum, comorbidities, and risk factor profile of cerebral palsy children: a prospective study. J Pediatr Neurosci 12:15–18

    Article  PubMed  PubMed Central  Google Scholar 

  45. Shang Q, Ma CY, Lv N, Lv ZL, Yan YB, Wu ZR, Li JJ, Duan JL, Zhu CL (2015) Clinical study of cerebral palsy in 408 children with periventricular leukomalacia. Experimental and therapeutic medicine 9:1336–1344

    Article  PubMed  PubMed Central  Google Scholar 

  46. Staudt M, Pavlova M, Bohm S, Grodd W, Krageloh-Mann I (2003) Pyramidal tract damage correlates with motor dysfunction in bilateral periventricular leukomalacia (PVL). Neuropediatrics 34:182–188

    Article  CAS  PubMed  Google Scholar 

  47. Cooper MS, Mackay MT, Fahey M, Reddihough D, Reid SM, Williams K, Harvey AS (2017) Seizures in children with cerebral palsy and white matter injury. Pediatrics 139:e20162975

    Article  PubMed  Google Scholar 

  48. Hirschberger RG, Kuban KCK, O'Shea TM, Joseph RM, Heeren T, Douglass LM, Stafstrom CE, Jara H, Frazier JA, Hirtz D, Rollins JV, Paneth N (2018) Co-occurrence and severity of neurodevelopmental burden (cognitive impairment, cerebral palsy, autism spectrum disorder, and epilepsy) at age ten years in children born extremely preterm. Pediatr Neurol 79:45–52

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Neurology, Kuang-Tien General Hospital, No. 117, Shatian Road, Shalu District, Taichung, 433, Taiwan, Republic of China

    Kuo-Liang Chiang

  2. Program of Health Administration, Tunghai University, No.1727, Sec.4, Taiwan Boulevard, Xitun District, Taichung, 40704, Taiwan

    Kuo-Liang Chiang & Chen-Yang Cheng

  3. Department of Nutrition, Hungkuang University, No. 1018, Section 6, Taiwan Boulevard, Shalu District, Taichung, 43302, Taiwan

    Kuo-Liang Chiang

  4. Department of Physical Therapy, Hungkuang University, No. 1018, Section 6, Taiwan Boulevard, Shalu District, Taichung, 43302, Taiwan

    Fang-Chuan Kuo

  5. Department of Industrial Engineering and Management, National Taipei University of Technology, Section 3, Zhongxiao East Road, Taipei, 10608, Taiwan, Republic of China

    Chen-Yang Cheng

  6. Department of Pediatrics, Taipei Veterans General Hospital, No.201, Section 2, Shipai Rd., Beitou District, Taipei, 11217, Taiwan

    Kai-Ping Chang

Authors
  1. Kuo-Liang Chiang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fang-Chuan Kuo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chen-Yang Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kai-Ping Chang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chen-Yang Cheng.

Ethics declarations

This study was approved by and conducted in accordance with the Institutional Review Board of Kuang-Tien General Hospital.

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chiang, KL., Kuo, FC., Cheng, CY. et al. Prevalence and demographic characteristics of comorbid epilepsy in children and adolescents with cerebral palsy: a nationwide population-based study. Childs Nerv Syst 35, 149–156 (2019). https://doi.org/10.1007/s00381-018-3920-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-018-3920-9

Keywords

Search

Navigation