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6 - Etiological and clinical evaluation of patients with spastic tetraplegic form of cerebral palsy
Zuhal Bilgen, Meral Özmen, Feyzullah Çetinkaya, Mehmet Emin Özen
Objective: To evaluate the etiology, associated problems, fre¬quency of epilepsy and the factors which affect antiepileptic therapy in children with spastic tetraplegia.
Methods: A total of 270 consecutive patients (60%males) aged 41-190 months (mean 68) with spastic tetraplegia were retrospectively studied. Type and frequency of epilepsy, EEG finding, cranial MRI finding and etiology of spastic tetraple¬gia were analysed.
Results: Follow up period ranged 15 and 35 months (mean 24 months). The % 54.5 of cerebral palsy were evaluated as spastic tetraplegia, hi the etiology the reasons were found as follow: prenatal in 33 patients, postnatal in 39 patients, peri¬natal ini47 patients. The most, frequent cranial MRI finding was cortical lesions (45.5 %). The frequency of epilepsy was 38 % in spastic tetraplegia. In 65 % of the epileptic patients, the onset age of epilepsy was under I year of age, and generalized convulsions were the most common type. Neona¬tal seizures and cranial cortical lesions associated with a hig¬her incidence of epilepsy. Regarding response to antiepileptic therapy there was not apparently any relationship between control of the seizure and the onset age of the epilepsy and the gender of the patients.
Conclusion: Epilepsy in spastic tetraplegia can be predicted if seizures occur in the neonatal period and if there is cort ical lesion in cranial MRI
Keywords: Spastic tetraplegia, epilepsy, antiepileptic therapy.
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