Discontinuation of Antiepileptic Drug Treatment After Two Seizure-free Years in Children With Cerebral Palsy

PEDIATRICS ◽  
1996 ◽  
Vol 97 (2) ◽  
pp. 192-197
Author(s):  
Mauricio R. Delgado ◽  
Anthony R. Riela ◽  
Janith Mills ◽  
Alan Pitt ◽  
Richard Browne
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Antiepileptic Drug ◽  
Spastic Diplegia ◽  
Multiple Factors ◽  
Spastic Hemiparesis ◽  
Children With Cerebral Palsy ◽  
Epileptic Children ◽  
Seizure Relapse ◽  
Antiepileptic Drug Treatment

Objective. The risk of seizure relapse after antiepileptic drug (AED) discontinuation in children has been reported to vary between 6% and 40%. It has been suggested that neurologic deficit and mental retardation are poor prognostic factors for seizure relapse after AED discontinuation. Because epileptic children with cerebral palsy (CP) have neurologic deficits, and many have mental retardation, it is important to know their risk for seizure relapse. Methods. AED treatment was discontinued in 65 children with CP and histories of epilepsy after 2 seizure-free years. All of the patients were followed until they had seizure relapses or for at least 2 years without seizures after AEDs were stopped. Multiple factors were analyzed for possible association with seizure relapse. Results. Twenty-seven patients (41.5%) had seizure relapses. Patients with spastic hemiparesis had the highest relapse rate (61.5%), and those with spastic diplegia had the lowest rate (14.3%). No other factor correlated significantly with the risk of seizure relapse. Conclusions. Discontinuation of AEDs in children with CP can, and should, be practiced when possible after patients have been seizure-free for at least 2 years. AED discontinuation in patients with spastic hemiparesis is significantly more likely to lead to seizure relapse than in patients with other CP types, but no other factor is yet known to increase the chance of relapse.

Developmental Enamel Defects in Primary Teeth in Children with Cerebral Palsy, Mental Retardation, or Hearing Defects: A Review

1989 ◽  
Vol 3 (2) ◽  
pp. 132-142 ◽  
Author(s):  
M. Bhat ◽  
K.B. Nelson
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Primary Teeth ◽  
Viral Infections ◽  
Dental Enamel ◽  
Tooth Germ ◽  
Developmental Defects ◽  
Enamel Defects ◽  
Children With Cerebral Palsy ◽  
Neurologic Development

Developmental enamel defects in primary teeth have been found at least twice as frequently in children with cerebral palsy or mental retardation as in control children, and frequently also in children with sensori-neural hearing deficits. The developing tooth germ is sensitive to a range of systemic disturbances, some of which may also affect neurologic development. Because the enamel cannot recover once it is damaged, it may provide a repository of information on the timing and nature of insults potentially affecting other ectodermally derived structures, including the brain. This paper reviews the literature on developmental defects of enamel in primary teeth, asking whether these might be useful as biological markers of the timing and in some cases the nature of insults. Among systemic factors related to development of enamel that might also have implications for neurologic development are certain genetic disorders including tuberous sclerosis, premature birth, neonatal nutritional disturbances (especially hypocalcemia), viral infections (such as rubella and cytomegalovirus during gestation), thyroid disorders, and maternal diabetes. It is concluded that further research is warranted concerning whether developmental defects of dental enamel can be useful markers for the timing of intra-uterine or perinatal events associated with certain neurologic and sensory disorders of children.

Immediate Effects of the Dorsiflexion Angle of Hinged Ankle-foot Orthosis on the Spatiotemporal Gait Parameters of Children With Spastic Cerebral Palsy

2021 ◽  
Author(s):  
IlHyun Son ◽  
GyuChang Lee
Keyword(s):  
Cerebral Palsy ◽  
Stride Length ◽  
Step Length ◽  
Gait Velocity ◽  
Spastic Cerebral Palsy ◽  
Spastic Diplegia ◽  
Ankle Foot Orthosis ◽  
Gait Parameters ◽  
Children With Cerebral Palsy ◽  
Foot Orthosis

Abstract Background: It has been reported the effects of a hinged ankle-foot orthosis on the gait ability of children with cerebral palsy. However, no studies investigated the effects of the dorsiflexion angle of the hinged ankle-foot orthosis on the spatiotemporal gait parameters of children with cerebral palsy. This study aimed to investigate the immediate effects of a 10° dorsiflexion inducing ankle-foot orthosis the spatiotemporal gait parameters of children with spastic diplegia compared to barefoot and a hinged ankle-foot orthosis.Methods: This study was cross-over design. 10 children with spastic diplegia were walked with barefoot, a hinged ankle-foot orthosis, and a 10° dorsiflexion inducing ankle-foot orthosis. GAITRite was used to collect the spatiotemporal gait parameters including gait velocity, cadence, step length, stride length, single leg support, and double leg support. Results: It showed that a 10° dorsiflexion inducing ankle-foot orthosis significantly improved the gait velocity, cadence, step length, stride length, single leg support, and double leg support than barefoot and a hinged ankle-foot orthosis (p<.05). Conclusion: The results of this study implied that a 10° dorsiflexion inducing ankle-foot orthosis could improve the gait ability of children with spastic diplegia more than barefoot or a hinged ankle-foot orthosis. High quality future studies will need to examine the effects of hinged ankle-foot orthosis on gait ability according to dorsiflexion angles.

scholarly journals Therapeutic effects of a horse riding simulator in children with cerebral palsy

2011 ◽  
Vol 69 (5) ◽  
pp. 799-804 ◽  
Author(s):  
Maria Beatriz Silva Borges ◽  
Maria José da Silva Werneck ◽  
Maria de Lourdes da Silva ◽  
Lenora Gandolfi ◽  
Riccardo Pratesi
Keyword(s):  
Cerebral Palsy ◽  
Postural Control ◽  
Qualité De Vie ◽  
Spastic Diplegia ◽  
Therapeutic Effects ◽  
Sitting Position ◽  
Post Intervention ◽  
Horse Riding ◽  
Children With Cerebral Palsy ◽  
Maximal Displacement

OBJECTIVE: To evaluate the efficacy of horse ridding simulator on the sitting postural control of children with spastic diplegia. METHOD: Forty children were randomly divided in a group using the simulator (RS) and a group performing conventional physical therapy (CT). FScan/Fmat equipment was used to register maximal displacement in antero-posterior (AP) and medio-lateral (ML) directions with children in sitting position. At the pre and post intervention stage both groups were classified according to the Gross Motor Function Classification System (GMFCS) and, after intervention, by the AUQEI questionnaire (Autoquestionnaire Qualité de vie Enfant Image). RESULTS: Comparison between groups disclosed statistically significant pos-intervention improvement both in the AP (p<0.0001) as in the ML (p<0.0069) direction in the RS group. CONCLUSION: The horse ridding simulator produced significant improvement in the postural control of children in sitting position, additionally showing a higher motor functionality and a better acceptance of the therapeutic intervention.

scholarly journals Stress and depression levels of mothers who give care to children with Cerebral Palsy and Mental Retardation: A comparison study

2018 ◽  
Vol 11 (1) ◽  
pp. 25-31
Author(s):  
Erdoğan Kavlak ◽  
Güzin Kara ◽  
Fatih Tekin ◽  
Filiz Altuğ ◽  
Nusret Ök ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Comparison Study ◽  
Children With Cerebral Palsy

GM1 Acupoint Injection Improves Mental Retardation in Children with Cerebral Palsy

2019 ◽  
Vol 67 (2) ◽  
pp. 305-311 ◽  
Author(s):  
Enyao Li ◽  
Pengju Zhao ◽  
Jie Jian ◽  
Hong Wu ◽  
Shuibo Gao ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Acupoint Injection ◽  
Children With Cerebral Palsy

Foot and ankle somatosensory deficits in children with cerebral palsy: A pilot study

2021 ◽  
pp. 1-9
Author(s):  
Anastasia Zarkou ◽  
Samuel C.K. Lee ◽  
Laura Prosser ◽  
Sungjae Hwang ◽  
Corinna Franklin ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Position Sense ◽  
Joint Position Sense ◽  
Medial Malleolus ◽  
Spastic Diplegia ◽  
Joint Position ◽  
Foot And Ankle ◽  
Light Touch ◽  
Children With Cerebral Palsy ◽  
Somatosensory Function

PURPOSE: To investigate foot and ankle somatosensory function in children with cerebral palsy (CP). METHODS: Ten children with spastic diplegia (age 15 ± 5 y; GMFCS I–III) and 11 typically developing (TD) peers (age 15 ± 10 y) participated in the study. Light touch pressure and two-point discrimination were assessed on the plantar side of the foot by using a monofilament kit and an aesthesiometer, respectively. The duration of vibration sensation at the first metatarsal head and medial malleolus was tested by a 128 Hz tuning fork. Joint position sense and kinesthesia in the ankle joint were also assessed. RESULTS: Children with CP demonstrated significantly higher light touch pressure and two-point discrimination thresholds compared to their TD peers. Individuals with CP perceived the vibration stimulus for a longer period compared to the TD participants. Finally, the CP group demonstrated significant impairments in joint position sense but not in kinesthesia of the ankle joints. CONCLUSIONS: These findings suggest that children with CP have foot and ankle tactile and proprioceptive deficits. Assessment of lower extremity somatosensory function should be included in clinical practice as it can guide clinicians in designing more effective treatment protocols to improve functional performance in CP.

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