The Characteristics And Related Risk Factors Of Epilepsy And EEG Discharge Patterns In Premature Infants With Cerebral Palsy

Purpose:To investigate the characteristics and related factors of epilepsy and electroencephalogram(EEG)discharge patterns in premature infants with cerebral palsy(CP).Methods:138 premature infants with CP who had been admitted at the Department of Neurological Rehabilitation,Qingdao Women and Children's Hospital from March 2014 to March 2016 were included.Precise history collection,long-range EEG monitoring,and imaging examination were conducted to analyze the status about epilepsyand EEG discharge patterns in premature infants with CP as well as the associated impact factors.Single factor Logistic regression analysis was used to screen the impacts of various factors,including brain imaging changes,neonatal seizures,perinatal asphyxia,birth gestational age,and birth weight,on the associated epilepsy and subclinical epileptiform discharges(SEDs)in premature infants with CP.Results:Among the 138 premature infants with CP,31 cases(22.46%)were accompanied by epilepsy,and 28 cases had only SEDsbut no epileptic seizures.17/31 cases(54.84%)in children with epilepsy had onset of epilesy before 1 year old,including all cases ofspastic extremities(5/5,100.00%).The first seizures in 11 children with spastic seizures were also within 1 years of age.The major epilepsy seizure types were focal attack(11/31,35.48%),spasm(11/31,35.48%),and generalized tonic-clonic seizure(GTCS)(6/31,19.35%).Among them,11 cases were diagnosed with West syndrome,3 cases of LGS syndrome,11 cases of focal epilepsy and 6 cases of generalized tonic-clonic epilepsy.7 cases of epilepsy with electrical status epilepticus during slow-wave sleep(ESES).Focal discharge was dominant among premature infants with CP accompanied by either epilepsy or SEDs,high loss of law in children with preterm cerebral palsy associated with epilepsy.In addition,neonatal seizure history(P<0.001,OR=15.358)was the related risk factors of epilepsy,the cortex/ subcortical(P<0.001,OR=16.250)andencephalomalacia(P<0.001,OR=12.883)impaired on imaging were the related risk factors of SEDs.ConclusionsPremature infants with cerebral palsy are frequently accompanied by epilepsy and SEDs.The first seizures in children with spastic limbs and spastic seizures are within 1years of age,mainly manifesting as the focal and attacks and spasms.The main electroencephalogram discharge mode is focal discharge.Epilepsy-associat encephalopathy and electric-clinical syndrome are also common with worse prognosis.Neonate seizure history may predict the implication of epilepsy in Premature infants with CP,the cortex/ subcortical and encephalomalacia may predict the implication of SEDs in Premature infants with CP.