-Status Dystonicus (SD) is characterized by generalized muscle contractions in dystonic patients. We report 5 cases of SD, two of which in patients with dystonic cerebral palsy, one in a patient with primary segmental dystonia, one in a patient with Hallervorden-Spatz syndrome and one in a patient with Wilson's disease (WD). Three patients were admitted to an intensive care unit and treated with propofol and midazolam, and two were submitted to neurosurgical procedures (bilateral pallidotomy and bilateral pallidal deep brain stimulation). Triggering factors were identified in three patients as follows: infection, stress-induced and zinc therapy for WD. On follow-up, two patients presented with significant improvement of dystonia, whereas the other three cases the clinical picture ultimately returned to baseline pre-SD condition.
Objective: To describe the prevalence and characteristics of epilepsy in patients with cerebral palsy in a tertiary center. Methods: a total of 100 consecutive patients with cerebral palsy were retrospectively studied. Criteria for inclusion were follow-up period for at least 2 years. Types and incidence of epilepsy were correlated with the different forms of cerebral palsy. Other factors associated with epilepsy such as age of first seizure, neonatal seizures and family history of epilepsy were also analysed. Results: follow-up ranged between 24 and 151 months (mean 57 months). The overall prevalence of epilepsy was 62%. Incidence of epilepsy was predominant in patients with hemiplegic and tetraplegic palsies: 70.6% and 66.1%, respectively. First seizure occurred during the first year of life in 74.2% of patients with epilepsy. Generalized and partial were the predominant types of epilepsy (61.3% and 27.4%, respectively). Thirty-three (53.2%) of 62 patients were seizure free for at least 1 year. Neonatal seizures and family history of epilepsy were associated with a higher incidence of epilepsy. Conclusions: epilepsy in cerebral palsy can be predicted if seizures occur in the first year of life, in neonatal period and if there is family history of epilepsy. KEY WORDS: epilepsy, cerebral palsy, neonatal seizures. Epilepsia em crianças com paralisia cerebral RESUMO-Objetivo: descrever sobre a prevalência e características da epilepsia em crianças com paralisia cerebral atendidas num serviço terciário. Método: um total de 100 pacientes com paralisia cerebral foi estudado retrospectivamente, tendo como critérios de inclusão o seguimento regular por pelo menos 2 anos. Os tipos e a incidência de epilepsia foram correlacionados com as diferentes formas de paralisia cerebral. Outros fatores associados com a ocorrência de epilepsia como idade da primeira crise, crises neonatais e história familiar de epilepsia também foram analisados. Resultados: o tempo de seguimento variou de 24 a 151 meses (média 57 meses). A prevalência total de epilepsia foi 62%. Os pacientes com as formas hemiplégicas e tetraplégicas de paralisia cerebral tiveram a maior incidência de epilepsia: 70,6% e 66,1%, respectivamente. A primeira crise ocorreu durante o primeiro ano de vida em 74,2% dos pacientes com epilepsia. As epilepsias do tipo generalizada e parcial foram as predominantes (61,3% e 27,4%, respectivamente). Trinta e três (53,2%) de 62 pacientes permaneciam há pelo menos um ano livres das crises. Crises neonatais e história familiar de epilepsia estiveram associadas com maior incidência de epilepsia. Conclusões: epilepsia na paralisia cerebral pode ser prevista se ocorrerem crises no primeiro ano de vida e no período neonatal, e se existe história familiar de epilepsia. Dr. Isak Bruck-CENEP Rua Floriano Essenfelder 81-80060-270 Curitiba PR-Brasil. Fax: (41) 264 9101 / 362 9380 Cerebral palsy (CP) is a chronic disorder of movement and posture. It is the result of a non-progressive damage of the immature nervous system caused by several...
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