51
|
Cooper MS, Mackay MT, Fahey M, Reddihough D, Reid SM, Williams K, Harvey AS. Seizures in Children With Cerebral Palsy and White Matter Injury. Pediatrics 2017; 139:peds.2016-2975. [PMID: 28209769 DOI: 10.1542/peds.2016-2975] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The goal of this study was to describe the prevalence, syndromes, and evolution of seizure disorders in children with cerebral palsy (CP) due to white matter injury (WMI). METHODS For this population-based cohort study, brain MRI scans and medical records were reviewed in children in the Victorian Cerebral Palsy Register born between 1999 and 2006 recorded as having WMI. Children were excluded if they had features of an undiagnosed syndrome, associated cortical malformation or injury, or no medical contact in the preceding year. Included were 166 children with CP and isolated WMI due to presumed vascular insufficiency or hemorrhage; 87 were born preterm. Seizure and CP details were obtained from medical records and interviews, and EEG recordings were reviewed. RESULTS Forty-one children (25%) had seizures beyond the neonatal period. Four children had West syndrome, which resolved with treatment. Thirteen children had febrile seizures that they outgrew. Thirty children had focal epilepsy with seizure manifestations and EEG discharges typical of early-onset childhood occipital epilepsy or childhood epilepsy with centrotemporal spikes; 23 have outgrown these seizures. Two children had idiopathic generalized epilepsy; it was ongoing in 1 child. Fourteen children had evolution from 1 epileptic syndrome to another. At last follow-up (median age, 12.7 years; minimum age, 9.7 years), 80% had not had a seizure for >2 years. CONCLUSIONS The electroclinical features of seizure disorders associated with CP and WMI are those of the age-limited, epileptic syndromes of childhood, with favorable outcome in the majority. The findings have important implications for counseling and drug treatment.
Collapse
Affiliation(s)
- Monica S Cooper
- The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Victoria, Australia.,Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; and
| | - Mark T Mackay
- The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Victoria, Australia.,Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; and
| | - Michael Fahey
- Department of Paediatrics, Monash University, Melbourne, Victoria, Australia
| | - Dinah Reddihough
- The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Victoria, Australia.,Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; and
| | - Susan M Reid
- The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Victoria, Australia.,Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; and
| | - Katrina Williams
- The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Victoria, Australia.,Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; and
| | - A Simon Harvey
- The Royal Children's Hospital, Melbourne, Victoria, Australia; .,Department of Paediatrics, The University of Melbourne, Victoria, Australia.,Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; and
| |
Collapse
|
52
|
Lai CJ, Chen CY, Chen CL, Chan PYS, Shen IH, Wu CY. Longitudinal changes in health-related quality of life in preschool children with cerebral palsy of different levels of motor severity. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 61:11-18. [PMID: 28040642 DOI: 10.1016/j.ridd.2016.11.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 10/15/2016] [Accepted: 11/19/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND When setting goals for cerebral palsy (CP) interventions, health-related quality of life (HRQoL) is an important outcome. AIMS To compare longitudinal changes in HRQoL in children with CP of different levels of motor severity. METHODS AND PROCEDURES Seventy-three children with CP were collected and classified into three groups based on Gross Motor Function Classification System (GMFCS) levels. HRQoL was assessed by parent's proxy of the TNO-AZL Preschool Quality of Life (TAPQOL) at baseline and 6 months later. OUTCOMES AND RESULTS Children with GMFCS level V had a lower total TAPQOL score and scores in all domains than those with level I-IV (p<0.01), except for the non-motor subdomain of physical functioning at follow-up. With regards to longitudinal changes, the children with GMFCS level V had greater improvements in physical (p=0.016) and cognitive functioning (p=0.042), but greater deterioration in emotional functioning (p=0.008) than those with levels I-II at 6 months of follow-up. CONCLUSIONS AND IMPLICATIONS Motor severity was associated with TAPQOL scores in all domains and changes in some domains in children with CP. Clinicians should early identify children at risk of a poor HRQoL and plan timely treatment strategies to enhance the HRQoL of children with CP.
Collapse
Affiliation(s)
- Chih-Jou Lai
- Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital and School of Medicine, No. 201, Sec.2, Shipai Rd., Beitou District, Taipei City, Taiwan 11217, Taiwan; National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, Taiwan 112, Taiwan; Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan.
| | - Chung-Yao Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taiwan.
| | - Chia-Ling Chen
- Graduate Institute of Early Intervention, College of Medicine, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan; Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital-Linkou, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan.
| | - Pei-Ying Sarah Chan
- Department of Occupational Therapy, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital-Linkuo, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan.
| | - I-Hsuan Shen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital-Linkou, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan; Department of Occupational Therapy, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan.
| | - Ching-Yi Wu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital-Linkou, No.5, Fu-Hsing St., Kwei-Shan, Taoyuan 333, Taiwan; Department of Occupational Therapy, Chang Gung University, No.259, Wen-Hwa 1st Rd, Kwei-Shan, Taoyuan 333, Taiwan.
| |
Collapse
|
53
|
Smithers-Sheedy H, McIntyre S, Gibson C, Meehan E, Scott H, Goldsmith S, Watson L, Badawi N, Walker K, Novak I, Blair E. A special supplement: findings from the Australian Cerebral Palsy Register, birth years 1993 to 2006. Dev Med Child Neurol 2016; 58 Suppl 2:5-10. [PMID: 26762930 DOI: 10.1111/dmcn.13026] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 11/30/2022]
Abstract
AIM To briefly outline the strengths and limitations of cerebral palsy (CP) registers, and to report on findings of the Australian Cerebral Palsy Register (ACPR) pertaining to a population cohort of children with CP. METHOD De-identified data were extracted from the ACPR for people with CP in birth years 1993 to 2006, from South Australia, Victoria, and Western Australia. Live birth prevalence of CP was estimated and risk factors described. RESULTS The overall birth prevalence of CP (including those whose CP was postneonatally acquired) for the 1993 to 2006 birth cohort was 2.1 per 1000 live births (95% confidence interval [CI] 2.0-2.2). Excluding cases with a known postneonatal cause, the birth prevalence for pre/perinatally acquired CP was 2.0 per 1000 live births (95% CI 1.9-2.1). A downward trend in rates of CP in those born extremely preterm was evident over at least three consecutive periods across all three regions. Most (58.6%) children were born at term (≥ 37 wks). Male sex, early gestational age, low birthweight, and multiple birth were risk factors for CP. INTERPRETATION Overall rates of CP did not change during this period. The proportion of those with CP born extremely preterm decreased. The ACPR Group will investigate whether this pattern continues when data pertaining to the next birth cohort for all three regions becomes available.
Collapse
Affiliation(s)
- Hayley Smithers-Sheedy
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, NSW, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia
| | - Catherine Gibson
- South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, SA, Australia
| | - Elaine Meehan
- Developmental Disability and Rehabilitation Research, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - Heather Scott
- South Australian Birth Defects Register, Women's and Children's Hospital, Women's and Children's Health Network, Adelaide, SA, Australia
| | - Shona Goldsmith
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, NSW, Australia
| | - Linda Watson
- Department of Health Western Australia, Perth, WA, Australia
| | - Nadia Badawi
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,Discipline of Paediatrics and Child Health, Sydney Medical School, The University of Sydney, NSW, Australia.,The Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Karen Walker
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia.,The Grace Centre for Newborn Care, The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Iona Novak
- Cerebral Palsy Alliance, The University of Sydney, Sydney, NSW, Australia
| | - Eve Blair
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | | |
Collapse
|