Abstracts

Children with cerebral palsy (CP) secondary to periventricular leukomalacia (PVL) often present with recurrent unprovoked epileptic seizures. To better understand the nature and source of these seizures, it is necessary to explore the distributions of and interplay between key clinical factors, most notably PVL severity and the age at onset of first seizure. All children at the regional CP treatment center having clinical patterns associated with PVL (spastic diparesis, triparesis, leg-dominant quadriparesis) were screened for epilepsy and radiological evidence of PVL. The extent and distribution of the PVL was rated radiologically in a blinded fashion, from PVL1 to PVL3, in order of increasing severity; those with additional focal cortical or subcortical pathology were scored as PVL4. Descriptive analyses were conducted on this sample, with special attention to severity grade of PVL and subjects[apos] age at first onset of seizures. Of 218 subjects with appropriate CP patterns, 157 had radiologically confirmed PVL and 130 had CT[plusmn]MRI studies available for scoring, with 37/130 having epilepsy; 22, 60, 40 and 8 patients were scored with PVL severity 1-4 respectively, while 5, 10, 17 and 5 had epilepsy. Among the patients with epilepsy, the mean age at onset of first seizure was 35.4 months (SD=41.4) and the median was 30.0 months (IQR=34.0). For those of PVL severity 1-4 respectively, the mean age at seizure onset was 34.0 (SD=4.9), 37.6 (SD=7.7), 31.3 (SD=12.3) and 56.6 months (SD=34.1). Age at onset was weakly inversely correlated with PVL severity (Spearman[rsquo]s rho= -0.302, p=0.05). In patients with PVL who develop epilepsy, there is some evidence of a weak relationship between PVL severity and the age at onset of first unprovoked seizure.