Epilepsy and cerebral palsy can co-occur due to shared risk factors and causes, such as injury to the brain during birth. Some people with cerebral palsy may experience epileptic seizures.

Epilepsy is common in people with cerebral palsy, as both conditions can occur from prenatal damage to the brain. Treatment for epilepsy in cerebral palsy focuses on seizure control and may include antiepileptic drugs.

This article looks at the link between cerebral palsy and epilepsy. It also outlines treatment options.

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Cerebral palsy is a group of disorders affecting movement and can also involve co-occurring epilepsy and changes in sensation, thinking, communication, and behavior. Epilepsy may affect around 40% of those with cerebral palsy.

Epilepsy may be more common in certain types of cerebral palsy, including dyskinetic or bilateral spastic-type cerebral palsy, or if additional impairments are present. Epilepsy may also occur more frequently in people with spastic quadriplegia and motor dysfunction.

Cerebral palsy and epilepsy share similar causes and risk factors, which explains why they may co-occur. Birth injuries may affect the brain and cause both conditions. Neonatal seizures can strongly indicate that someone with cerebral palsy may develop epilepsy.

A 2020 study found that children with cerebral palsy may experience focal and generalized seizures.

Focal seizures

Focal or partial seizures affect one area of the brain. Focal seizures include:

  • Simple focal seizure: A simple focal seizure only affects a small area of the brain. It may cause changes in sensation, such as taste or smell, and mild involuntary movements, such as twitching.
  • Complex focal seizure: A complex focal seizure may cause people to feel confused or dazed. They may temporarily be unable to respond to directions or questions.

People may also have a secondary generalized seizure. This starts as a focal seizure in one area and then spreads to both sides of the brain.

Generalized seizures

Generalized seizures involve both sides of the brain. Generalized seizures include:

  • Absence seizure: An absence or petit mal seizure may cause people to blink rapidly or stare into space for a few seconds.
  • Tonic-clonic seizure: A tonic-clonic or grand mal seizure may cause a person to cry out, fall to the floor, have muscle jerks or spasms, or lose consciousness.

The 2020 study also found that children with cerebral palsy may experience the below.

Neonatal seizures

Neonatal seizures are a neurological condition in which a newborn has atypical electrical activity in the brain. Atypical electroencephalography (EEG) test results may indicate a newborn has cerebral palsy and epilepsy and will start to develop signs and symptoms during infancy. Spikes on an EEG may link to a 30% risk of developing epilepsy.

West syndrome

West syndrome is a collection of symptoms that may begin in the first few months after birth but can also occur during early childhood. West syndrome can cause infantile spasms, which may be mild or severe. It also causes developmental cognitive and physical problems and shows a specific pattern of changes on an EEG.

Epileptic encephalopathy

Epileptic encephalopathy is a group of severe epilepsies that are usually drug-resistant. These conditions have links to widespread brain inflammation or brain malformation and may cause difficulties with speech, learning, and physical mobility.

Cerebral palsy and epilepsy share similar causes and risk factors, which may occur at birth. These include brain abnormalities or disorders that occur in the womb and are present at birth or a lack of oxygen during pregnancy or around birth.

These may lead to incomplete development of brain tissue, brain injury, or a deficiency in the amount of brain tissue with large fluid-filled spaces in the brain. This impairs communication between brain cells and connections. The type and location of the brain condition may affect the type of seizures and symptoms people experience.

According to a 2020 study, treating epilepsy in cerebral palsy may include one or more antiepileptic drugs. First-line medications include:

Second-line medications may include:

If treatment with a single drug is ineffective in treating cerebral palsy with epilepsy, doctors may recommend combining drugs, which they call polytherapy.

Treatment may help provide seizure control in people with cerebral palsy and epilepsy. Treatment outcomes may depend on the type of epilepsy individuals have and the seizure type.

Cerebral palsy and epilepsy may co-occur due to similar causes and risk factors. Prenatal problems or birth complications may lead to changes in the brain that cause both conditions.

People with cerebral palsy may have focal or generalized seizures or other epileptic conditions, such as West syndrome.

Treatment for seizures in people with cerebral palsy may include antiepileptic drugs. Sometimes, individuals may require a combination of therapies.