Epilepsy and cerebral palsy

Abstract

Children who have both cerebral palsy and epilepsy are liable to be deemed ineducable and mentally defective, whatever their intellectual potentialities. Epilepsy in association with cerebral palsy is due to a gross brain lesion. This is probably true of many other cases of epilepsy, including the 'idiopathic' variety. Figures for the Fountain Hospital group based on 806 beds are given. These patients are mainly children certified as mentally defective. Two hundred and twenty-eight cases of cerebral palsy and 265 of epilepsy have been recorded in the past five years. Forty-five per cent of the cases of cerebral palsy were also classed as epileptic (fits observed in hospital). The athetotic and ataxic patients had a low incidence of epilepsy. The frequency of fits in epileptic subjects as recorded increased after infancy but declined with puberty. The evidence suggests that cases of cerebral palsy with epilepsy are likely to be less intelligent on the average than those without this complication. The electroencephalographic recordings show that 'epileptic type' phenomena also occur in patients who have not had fits recorded in hospital. As all the patients in this group, except the small minority of athetotic and ataxic patients, had gross cortical lesions, there is no evidence in this material to support the thesis of sub-cortical epileptic foci. Morbid anatomy showed a wide variety of lesions of which reduction in brain size and gliosis were the most constant. All the brains were very abnormal and most had gross structural abnormalities.