Prevalence of and Factors Associated With Epilepsy in Children With Cerebral Palsy at Kenyatta National Hospital; a Descriptive Cross-sectional Study

Abstract

Background: Cerebral palsy (CP) is one of the most common neurologic disorders in children, often complicated with other disabilities. These include epilepsy, intellectual disability and feeding disorders. Epilepsy is the most commonly associated comorbidity and often confers a poor prognosis compared to those without epilepsy Aim and objective: This study aimed to determine the prevalence of epilepsy and associated factors among children diagnosed with cerebral Palsy at the Kenyatta National Hospital. Methodology: This hospital based cross sectional study that was conducted at Kenyatta National Hospital, enrolled 156 children aged 12 months to 12 years with diagnosis of cerebral Palsy receiving services at the physiotherapy clinic, occupational therapy clinic and paediatric wards. A structured questionnaire was used for data collection. The questionnaire included questions on demographic factors of mother and child, cerebral palsy diagnosis and Gross Motor Function Classification System (GMFCS) assessment. Results: The prevalence of Epilepsy among Cerebral palsy children was 63% ,95% CI:55.4-71%. Among CP patients with epilepsy, 62.6% were female, 49.5% were resuscitated at birth, 76.8% were admitted to Newborn Unit, 54.5% had quadriplegia while 75.8% had spastic CP. The findings also revealed that 59.6% of the children had neurologic impairment severity grade IV – V. Multivariable analysis revealed that admission into New Born Unit and GMFCS score IV – V were independently associated with epilepsy in CP (AOR =12.31, 95%CI: 5.55 – 98.07, p =0.018), GMFCS classification (IV-V), AOR =3.64, 95%CI: 1.69 – 19.14, p<0.001) Conclusion and recommendations: The prevalence of epilepsy in CP patients is high occurring in more than half of the patients. The predominant seizure type was generalized seizures. Other associated clinical manifestations included spasticity and severe neurological impairment (GMFCS IV and V). The associated risk factors for epilepsy in CP included birth asphyxia and admission in to NBU. There is need for routine screening for epilepsy among children with cerebral palsy with a history of birth asphyxia and severe neurological impairment.