| Objective:To explore the types of cerebral palsy and seizures,head imaging and electroencephalogram on children with cerebral palsy and epilepsy,to clarify the clinical characteristics of cerebral palsy with epilepsy;to explore the effects of exercise therapy and low-frequency repetitive transcranial magnetic stimulation on children with cerebral palsy and epilepsy;to clarify the clinical efficacy and application value of its combination therapy;and to provide theoretical guidance for the rehabilitation treatment to patients with cerebral palsy complicated with epilepsy.Methods:The clinical data of 96 children with cerebral palsy and epilepsy and 65 children with cerebral palsy without epilepsy admitted from January 2019 to October 2020 was retrospectively analyzed.The two groups of patients were analyzed including cerebral palsy and seizure type,head differences in imaging and electroencephalogram and other clinical related data,and 96 children with cerebral palsy and epilepsy were randomly divided into a control group and an observation group,with 48 cases in each group.The control group received exercise therapy combined with pseudo-stimulation coil transcranial magnetic stimulation.The observation group were implemented exercise therapy combined with low-frequency repetitive transcranial magnetic stimulation.Then muscle tone scores(MAS),gross motor function scores,independence and autonomy and other related indicators of patients were collected before and after treatment,and analyzed using SPSS software(version 23.0).Result:1.Clinical characteristics of children with cerebral palsy and epilepsy(1)Comparison of the types of cerebral palsy between children with epilepsy and children without epilepsyThe results showed that among the 65 patients with cerebral palsy but without epilepsy,4cases were mixed cerebral palsy(6.15%),8 cases were involuntary cerebral palsy(12.3%),3cases were ataxia cerebral palsy(4.61%),8 cases were spastic hemiplegia(12.3%),27 cases were spastic diplegia(41.5%),and 15 cases were spastic tetraplegia(23.0%),while 3 cases were mixed cerebral palsy(3.12%)of 96 cases of cerebral palsy and epilepsy,10 cases were involuntary cerebral palsy(10.4%),3 cases were ataxia cerebral palsy(3.12%),27 cases were spastic hemiplegia(28.1%),11 cases were spastic diplegia(11.5%),and 42 cases were spastic tetraplegia(43.7%).There was a statistical difference in the proportion of children in the group in spastic hemiplegia(X~2=1.112,P=0.023),diplegia(X~2=1.973,P<0.001)and tetraplegia(X~2=3.446,P<0.001).(2)Types of epilepsy on children with cerebral palsy and epilepsyThe results of the study showed that among children with cerebral palsy and epilepsy,there were 43 cases of tonic-clonic seizures(44.7%),83 cases of tonic seizures(8.33%),6 cases of clonic seizures(6.25%),22 cases of partial seizures(22.9%),8 cases of myoclonic seizures(8.33%),2 cases of atonic seizures(2.08%),7 cases of West syndrome(7.29%),and 2 cases of absence seizures(2.08%).(3)Comparison of head imaging changes between children with cerebral palsy and epilepsy and children without epilepsyCompared with the children of the cerebral palsy without epilepsy group,the children of cerebral palsy combined with epilepsy group had thalamic or basal ganglia damage(X~2=2.197,P=0.028),gray matter or gray matter damage(X~2=1.337,P=0.035)and infection in brain imaging or the abnormal rate of developmental abnormalities(X~2=1.037,P<0.001)significantly higher,while the white matter damage(X~2=1.554,P<0.001)was significantly lower.The difference was statistically significant.(4)Comparison of EEG characteristics of the children with cerebral palsy and epilepsy and children without epilepsyThe results of the study showed that the localized epileptiform discharges(52.1%)and generalized epileptiform discharges(31.3%)on the children of the cerebral palsy combined with epilepsy group were significantly higher.Compared with the children of the cerebral palsy without epilepsy group,the children of cerebral palsy combined with epilepsy group suffered from the incidence of generalized epileptic discharge(X~2=3.115,P<0.001)and focal epileptic discharge(X~2=2.006,P<0.001)of children’s EEG significantly higher,while non-specific abnormalities(X~2=1.553,P=0.015)and no abnormalities(X~2=2.152,P<0.001)were significantly lower.The difference was statistically significant.2.Research on the different rehabilitation treatment to children with cerebral palsy and epilepsy(1)Comparison of gross motor function scores before and after rehabilitation between the two groupsThere was no significant difference in gross motor function scores between the two groups before treatment(P>0.05).After rehabilitation,the gross motor function scores of the two groups were significantly improved,and the scores of the observation group was significantly higher than the control group’s,and the difference was statistically significant(P<0.05).(2)Comparison of fine motor function motor scores between the two groupsThe results of the study of the fine motor function motor scores of the two groups of patients showed that there was no statistical difference in the visual-motor comprehensive ability scores and the grasping ability scores of the two groups of patients before treatment(P>0.05).After treatment,sports comprehensive ability scores and grasping ability scores increased significantly,and the scores of the observation group was significantly higher than the control group’s,and the difference was statistically significant(P<0.05).(3)Comparison of effective rate of muscle tension reduction before and after treatment in the two groupsThe results of the study showed that compared with the control group,the observation group(95.8%)had a significantly higher effective rate of muscle tension reduction after treatment than the control group(85.5%),and the difference was statistically significant(X~2=2.667,P=0.039)(4)Comparison of the developmental quotient of the two groups of patients before and after treatmentComparing the developmental quotient scores of the two groups of patients before and after treatment showed that there was no statistical difference in the developmental quotient of the two groups before treatment(P>0.05).After rehabilitation,the developmental quotient scores of children in the two groups increased significantly,and the difference was statistically significant,and the observation group was significantly higher than the control group.The difference was statistically significant(P<0.05).(5)Comparison of the activities of daily living of the two groups of patients before and after treatmentThe results of the study showed that there was no statistical difference in the activity of daily living scores between the two groups of patients before rehabilitation(P>0.05).After rehabilitation,the activities of daily living of the two groups were significantly increased,and the scores of the observation group were significantly higher than the control group’s.The difference was statistically significant(P<0.05).Conclusion:1.Among the patients with cerebral palsy,patients with spastic tetraplegia are most likely to develop epilepsy.2.Abnormal head imaging and EEG data have important value to the early diagnosis of epilepsy on patients with cerebral palsy.3.For children with cerebral palsy and epilepsy,exercise therapy can effectively improve the children’s gross motor function,fine motor function,muscle tone and other motor dysfunctions.However,its combined application with low-frequency repetitive transcranial magnetic stimulation is more effective,and it is well worth of clinical promotion. |
