Are Cerebral Palsy & Epilepsy connected

Around half of all children with cerebral palsy also have epilepsy. Both cerebral palsy and epilepsy are neurological disorders that often coexist with one another.

What is Epilepsy?

According to the National Institute of Neurological Disorders, epilepsy encompasses a “spectrum of brain disorders,” in which the pattern of normal neuronal activity is disrupted. [1] When the activity of brain cells, or neurons, is disturbed, convulsions (known as seizures) and muscle spasms result.

During these episodes, some children will experience loss of consciousness. As the fourth most common neurological disorder in the world, epilepsy can affect anyone at any age. Around 1 out of every 100,000 people develop epilepsy each year.

There are a number of different types of seizures, and people with epilepsy may experience one or several of the various types. It’s important to note that there is a difference between epilepsy and seizures. Someone who has only one seizure generally does not have epilepsy.

Epilepsy is marked by recurrent seizures. If someone has at least two but usually more seizures as an ongoing condition, they are more likely to be diagnosed with a seizure disorder, otherwise known as epilepsy.

What Causes Epilepsy?

For about half of epilepsy cases, there’s no known cause. Among the known causes of epilepsy, the most common include:

Prenatal Injuries

During intrauterine life, the developing brain of a fetus is highly susceptible to damage. This can occur from prenatal infections, maternal alcohol and drug use, when the oxygen or blood supply is low, and with poor nutrition or vitamin deficiencies.

Developmental and Genetic Disorders 

As mentioned earlier, cerebral palsy and epilepsy often coexist. Other neurodevelopmental and genetic disorders that can be associated with epilepsy include conditions like autism, neurofibromatosis, Angelman syndrome, and many others.

Sometimes a mutation in one or more genes can cause abnormalities in the brain that can be passed down and make a whole family more susceptible to epilepsy or other brain disorders.

Head Trauma

Head trauma, such as birth injuries, motor vehicle collisions, or any accident in which the head undergoes traumatic damage can lead to epilepsy. [2]

Diseases

A number of infectious diseases can cause direct damage to brain tissue, such as viral encephalitis and meningitis, which can result in epilepsy.

Oxygen Loss 

Any significant lack of oxygen to the brain before, during, or after birth, can cause seizures in babies. This can also occur with people of any age with a stroke, which is a bleed or obstruction to the blood flow in the brain. The brain damage that occurs is very often permanent and may leave the child with a seizure disorder.

What are the Symptoms of Epilepsy?

The main symptom of epilepsy is recurrent seizures, which are marked by any of the following:

  • Uncontrollable, jerking body movements, usually in the arms and legs
  • Repetitive movements of the face, including lip-smacking or chewing
  • Loss of awareness
  • Drooling
  • Difficulty talking
  • Rigid, tense muscles
  • The skin may look pale or flushed
  • Racing heart
  • Dilated pupils or staring
  • Sweating
  • Tongue biting
  • Tremors

Keep in mind that not every child will experience all of these symptoms.

Epilepsy Treatment

Physicians usually treat epilepsy with medication. [3] The type of medicine prescribed is based on the particular seizure type experienced by the child. However, since each child is different, finding the correct medication, along with the right dosage, can be an arduous process.

Doctors usually prescribe the first medication at a low dosage to see how effective it is, and how many side effects the child will experience. Most epilepsy medications have significant side effects, especially when they are first started, which can include dizziness, weight gain, fatigue, nausea, skin rashes, and more, depending on which medication is prescribed.

Over half of the people who begin medication find success with this method of treatment, and with continued use, may even eventually become seizure-free. There are some for whom the medication works well to control the seizures, but they will have to continue on medicine for life in order to remain seizure-free.

If medications fail to work, physicians may recommend a treatment called vagus nerve stimulation. This involves the placement of a small device into the patient’s chest. This device sends low levels of electrical energy to stimulate the vagus nerve, which may reduce seizure activity between 20% and 40%.

The ketogenic diet is another treatment option for epilepsy that fails to respond to medication. It’s a strict diet, however, that entails substantially lowering carbohydrates while increasing fats. The body will then use fat for energy, as opposed to carbohydrates.

It is a difficult diet for families to follow because of the severe limitations in what the child may eat, as well as the continuous need to monitor for ketones.

You’ll need to work closely with your physician, as well as a dietitian or nutritional counselor, if you decide to have your child try the ketogenic diet, as some children may experience adverse side effects, including dehydration and nutritional deficiencies.

However, with proper medical supervision, the side effects are not too common. Around 10% to 15% of children who go on the ketogenic diet are seizure-free within a year, although it is very rare for people to be able to stay on this diet successfully for long periods of time.

If all other treatments have been exhausted, surgery may be considered as the next option. Surgical procedures are generally only performed as a last resort, and when doctors determine that the seizures occur in a specific part of the brain that doesn’t hinder vision, speech, hearing, or motor function. During the operation, the part of the brain that’s causing seizures is removed.

Studies on Cerebral Palsy and Epilepsy

According to a scientific study published in the European Journal of Epilepsy, spastic quadriplegia and spastic diplegia are the most common types of cerebral palsy associated with epilepsy. [4] Symptoms of epilepsy generally start for children with cerebral palsy during the first year of life, some within the first month after birth.

Epilepsy Prognosis

If children respond well to medication, there’s a good chance that they’ll be seizure-free one day, and may even be able to discontinue epilepsy medication use. It is important to note, however, that many children with cerebral palsy will need to remain on medication to control their seizures for life.

The University of Maryland Medical Center (UMM) states that long-term survival rates are lowered when traditional treatment options, such as medications and surgery, fail to work. Accidents from uncontrollable seizures also play into the lower survival rate.

These are cases in which the severity of the seizure disorder is part of an overall more severe form of cerebral palsy, and many other organ systems are affected, leading to a shortened life span.

Cerebral Palsy and Pregnancy

Brain damage during pregnancy can have severe effects on a child and can occur for many different reasons. In any case where a child is born with cerebral palsy, there will be an investigation into the cause of that brain damage so that doctors can determine what happened. There may be a range of reasons that a child’s brain was damaged at birth, but some of them are more common than others are.

Brain injuries that occur during pregnancy can have many different causes. Genetics can certainly play a role. In some cases, the genetic factors involved will prevent the brain cells from forming and migrating where they would normally be located, and this can lead to cerebral palsy.

There is also a condition that sometimes causes cerebral palsy that involves the development of nerve cell fibers. These fibers have a protective covering that sometimes fails to form as expected. When this happens, it can cause problems with the nerves being able to transmit signals as they normally.

Illnesses

Sometimes, the mother will contract an infection or other ailment that will end up harming the child while they’re in the womb. This may not be known until the child is born and the condition is actually diagnosed. In such cases, it may be found that the damage could not have been prevented, or conversely, the child may have been damaged due to a lack of appropriate and timely care or due to another medical mistake. It’s important to understand that not all brain damage is the result of a mistake on any medical provider, or most certainly, not because of anything the mother did. Sometimes, people simply fall ill and brain damage is a result of that illness.

Pregnancy Complications

Children sometimes suffer brain damage in the womb due to low amniotic fluid or for other reasons. This is sometimes avoidable, sometimes, not. When a woman has a high-risk pregnancy, doctors may recommend that a Cesarean section is performed to minimize the risk to mother and child. With today’s medical technology, it’s much easier for physicians to detect these issues before they manifest into more serious problems, and because of that, children are oftentimes spared such injuries today when they almost certainly would have suffered them before.

Trauma

Sometimes, trauma that ruptures blood vessels or that causes oxygen deprivation can end up causing CP injuries. This trauma may occur in the womb or it may occur during birth. The trauma can sometimes cause the connections that provide proper communication between the nerves and the brain cells to be severed, as well, and this can lead to cerebral palsy in the newborn.

Cases where trauma could have been prevented are among the most tragic cases when children end up suffering with CP. This is sometimes the result of negligence on the part of a physician, a midwife or a nurse. There are options for the families that have been affected by this type of negligence and it’s not necessary for those families to assume that they’re on their own in these instances.

Negligence

Negligence is sometimes the reason that children suffer brain damage during pregnancy. This may be because the doctor fails to diagnose a condition or because they make a wrong diagnosis. It also may be because the doctor fails to deliver care that the child and mother need, creating a delay during which the child is injured.

In situations where negligence is the issue that caused the injury, the families sometimes sue for compensation. This is one way that they can get financial assistance so that they can support their child. These cases do not always win but, when they do, the jury awards or settlements are sometimes enough to help the family pay for needed medical care.