Michael S. Porter
Eric C. Nordby
Seizures are one of the most common complications experienced by children with cerebral palsy. Understanding the connection between these two conditions can help families recognize symptoms early, seek appropriate care, and work with medical teams to manage seizures effectively. If your child has been diagnosed with cerebral palsy, learning about seizure risk, warning signs, and treatment options can give you a clearer sense of what to watch for and how to respond.
This page explains what seizures are, why they occur more often in children with cerebral palsy, how they are diagnosed and treated, and what families in New York and across the country can expect as part of long-term care.
Why Seizures Occur in Children with Cerebral Palsy
Cerebral palsy is caused by damage to the developing brain, often before or during birth. The same brain injury or abnormality that leads to motor impairments can also disrupt the brain’s electrical activity, which can result in seizures.
A seizure happens when there is a sudden surge of electrical activity in the brain. This can cause changes in behavior, movement, sensation, or consciousness. When a child has two or more unprovoked seizures, they are typically diagnosed with epilepsy.
According to the Centers for Disease Control and Prevention, between 35% and 44% of children with cerebral palsy also have epilepsy. This makes seizures one of the most frequently occurring secondary conditions in this population.
The likelihood of seizures varies depending on the type and severity of cerebral palsy. Children with spastic quadriplegic cerebral palsy, which affects all four limbs and is often associated with more extensive brain injury, are at highest risk. Those with spastic diplegia or hemiplegia also face increased risk, though to a lesser degree.
When Seizures Typically Begin
Most children with cerebral palsy who develop epilepsy will have their first seizure during infancy. Research shows that approximately 69% of children with both conditions experience their first seizure before their first birthday.
This early onset makes it especially important for parents and caregivers to be aware of seizure symptoms during the first year of life. Early recognition allows for faster diagnosis and treatment, which can improve both seizure control and developmental outcomes.
Types of Seizures Seen in Cerebral Palsy
Children with cerebral palsy can experience different types of seizures. The specific type depends on which part of the brain is affected and how the electrical activity spreads.
Common seizure types include the following.
Generalized seizures affect both sides of the brain at once. They may cause loss of consciousness, muscle stiffening, jerking movements, or brief lapses in awareness. Tonic-clonic seizures, previously known as grand mal seizures, are a well-known example.
Focal seizures start in one area of the brain and may or may not spread. Symptoms can include twitching in one part of the body, unusual sensations, repetitive movements, or changes in emotions or awareness. Some focal seizures are easily mistaken for other movement issues common in cerebral palsy.
Febrile seizures can occur in response to a fever, particularly in young children. While these are not considered epilepsy on their own, children with cerebral palsy may experience them more frequently.
It is also important to note that not all unusual movements in a child with cerebral palsy are seizures. Some may be related to the movement disorder itself. This is why careful observation and medical evaluation are essential.
Risk Factors That Increase Seizure Likelihood
Certain factors increase the chance that a child with cerebral palsy will develop epilepsy. These include events or conditions present at birth or in early development.
Perinatal infections such as chorioamnionitis or other maternal infections during pregnancy can increase the risk of both cerebral palsy and seizures.
Neonatal seizures that occur in the first few days or weeks of life are a strong predictor of later epilepsy, especially in children who go on to develop cerebral palsy.
Low Apgar scores at birth, which reflect a newborn’s overall condition immediately after delivery, may suggest possible oxygen deprivation or distress that may affect the brain.
Severe motor impairment and significant intellectual disability are associated with a higher likelihood of seizures and may make those seizures more difficult to control.
Specific patterns of brain injury visible on imaging studies, such as cortical malformations or widespread damage, are linked to higher seizure risk.
Understanding these risk factors helps doctors anticipate seizure development and begin monitoring or treatment early.
How Seizures Are Diagnosed
Diagnosing epilepsy in a child with cerebral palsy requires a thorough evaluation by a neurologist or other specialist familiar with both conditions. The process typically includes several steps.
The doctor will take a detailed medical history, asking about the child’s birth, developmental milestones, and any events that may have looked like seizures. Parents and caregivers may be asked to describe what they observed in detail, including how long the episode lasted, what the child was doing, and how they acted afterward.
An electroencephalogram, or EEG, is the primary test used to diagnose epilepsy. This test measures electrical activity in the brain using small sensors placed on the scalp. Abnormal patterns can help confirm a diagnosis and identify the type of seizure disorder.
In some cases, brain imaging such as an MRI may be used to look for structural abnormalities or areas of injury that could be causing seizures. This is especially helpful when seizures are difficult to control or when surgery is being considered.
Because some seizure symptoms can resemble the involuntary movements associated with cerebral palsy, diagnosis may require careful observation over time. Video EEG monitoring, where the child is recorded while brain activity is measured, can be particularly useful in complex cases.
Treatment and Management of Seizures
The goal of seizure treatment in children with cerebral palsy is to reduce or eliminate seizures while minimizing side effects and supporting overall development and quality of life.
Antiepileptic Medications
The first line of treatment is usually medication. Antiepileptic drugs work by stabilizing electrical activity in the brain. Commonly prescribed medications include levetiracetam, valproic acid, lamotrigine, and others. The choice of medication depends on the type of seizure, the child’s age, other health conditions, and how well the drug is tolerated.
According to medical research, about 65% of children with cerebral palsy and epilepsy achieve complete seizure control with medication. However, roughly half of all children with both conditions will continue to have seizures that require adjustments in treatment, combinations of drugs, or additional therapies.
Drug-Resistant Epilepsy
When seizures continue despite trying two or more appropriate medications, the condition is considered drug-resistant epilepsy. This affects about 25% of children with cerebral palsy and epilepsy, particularly those with more severe forms of cerebral palsy or extensive brain injury.
For these children, additional treatment options may include the following.
Dietary therapy, such as the ketogenic diet, is a high-fat, low-carbohydrate diet that has been shown to reduce seizures in some children who do not respond to medications. This diet requires careful medical supervision and support from a dietitian.
Non-invasive brain stimulation techniques, including vagus nerve stimulation, use electrical signals to help regulate brain activity and reduce seizure frequency.
Surgical options may be considered in select cases where seizures originate from a specific area of the brain that can be safely removed or disconnected. Surgery is typically reserved for children with severe, localized epilepsy that does not respond to other treatments.
Ongoing Monitoring and Care Coordination
Children with cerebral palsy and epilepsy benefit from regular follow-up with a team of specialists. This often includes a pediatric neurologist, developmental pediatrician, epilepsy specialist, and other providers depending on the child’s needs.
Families should have an emergency seizure action plan in place, especially if seizures are frequent or severe. This plan should outline when to give rescue medication, when to call 911, and what information to share with emergency responders.
For families in New York, specialized epilepsy centers at hospitals such as Mount Sinai, NYU Langone Health, NewYork-Presbyterian, and Albany Medical Center offer comprehensive care, advanced diagnostics, and access to clinical trials and emerging therapies.
Long-Term Outlook and Prognosis
The long-term outlook for children with cerebral palsy and epilepsy varies widely depending on the severity of both conditions, the type of seizures, and how well they respond to treatment.
Many children do well over time. Research shows that up to 50% of children with cerebral palsy and epilepsy may eventually become seizure-free and, in some cases, successfully discontinue antiepileptic medications after several years of seizure control.
For others, particularly those with severe cerebral palsy, intellectual disability, or complex brain injury, seizures may remain a long-term challenge. Even in these cases, treatment can often reduce seizure frequency and improve quality of life.
Seizures are considered a significant factor in overall development and function. Children who achieve good seizure control tend to have better cognitive outcomes, fewer hospitalizations, and greater independence in daily activities.
Supporting Your Child at Home and School
Managing seizures requires vigilance, but it does not mean your child cannot participate in everyday activities. With the right precautions and support, most children with cerebral palsy and epilepsy can attend school, play, and engage with their families and communities.
At home, keep the environment safe. Avoid situations where a seizure could lead to injury, such as unsupervised bathing or activities near open flames or heavy machinery. Make sure caregivers, family members, and babysitters know what to do if a seizure occurs.
At school, work with your child’s care team to create an individualized education plan or 504 plan that includes accommodations for seizures. This may involve training school staff to recognize and respond to seizures, having rescue medication available, and allowing extra time for assignments if seizures affect attention or memory.
Communication between home, school, and medical providers is essential. Keep a seizure log that tracks when seizures happen, how long they last, and any patterns you notice. Share this information with your child’s doctor at each visit.
Resources and Support for Families
Navigating cerebral palsy and epilepsy can feel overwhelming, but you are not alone. Many families face similar challenges, and there are resources available to help.
The New York State Department of Health offers programs and services for children with special health care needs, including care coordination and connections to specialists.
National organizations such as the Epilepsy Foundation and United Cerebral Palsy provide education, advocacy, and support groups for families.
NYBirthInjury.com is here to provide trusted, medically accurate information and connect families with qualified medical and support resources across New York and the United States. Whether you are just beginning to understand your child’s diagnosis or looking for guidance on treatment options, clear and compassionate information can make a meaningful difference.
Moving Forward with Confidence
Learning that your child has both cerebral palsy and epilepsy can be difficult. But with early diagnosis, appropriate treatment, and a strong support system, many children go on to lead full and meaningful lives.
Stay informed, ask questions, and work closely with your medical team. Trust your instincts as a parent, and do not hesitate to seek second opinions or additional resources when needed. You are your child’s best advocate, and the more you understand about their condition, the better equipped you will be to help them thrive.