Cerebral Palsy and Epilepsy

When a child is diagnosed with cerebral palsy, families often learn that other conditions may also be present. Epilepsy is one of the most common co-occurring neurological conditions in children with CP. Understanding the connection between cerebral palsy and epilepsy can help parents recognize symptoms early, seek appropriate medical care, and plan for the comprehensive support their child may need.

This page explains why epilepsy occurs more frequently in children with cerebral palsy, the types of seizures that may develop, how epilepsy is diagnosed and treated, and what families can expect over time. Our goal is to provide clear, accurate information that helps you make informed decisions and feel more confident navigating your child’s care.

Why Epilepsy and Cerebral Palsy Often Occur Together

Cerebral palsy is caused by injury to or abnormal development of the brain during pregnancy, birth, or early infancy. Epilepsy, which involves recurring, unprovoked seizures, arises from similar types of brain injury or disruption. Because both conditions stem from damage to the developing brain, they frequently occur in the same child.

Not every child with cerebral palsy will develop epilepsy, but the risk is significantly higher than in the general population. Large studies, including data from the CDC and other national surveillance programs, show that approximately 40 to 45 percent of children with cerebral palsy also have epilepsy. This makes epilepsy one of the most common neurological complications associated with cerebral palsy.

Which Children Are at Higher Risk

The likelihood of developing epilepsy varies depending on several factors related to 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, have the highest rates of epilepsy. Those with hemiplegic or diplegic forms of cerebral palsy are also at elevated risk, though typically to a lesser degree.

Additional factors that increase the chance of epilepsy include:

• Severe motor impairment
• Intellectual disability or significant cognitive delays
• A history of neonatal seizures
• Abnormal findings on brain imaging, such as MRI
• Perinatal infections or other complications during or shortly after birth

The more severe the brain injury, the more likely a child is to develop both significant motor impairment and epilepsy.

Types of Seizures in Children with Cerebral Palsy

Epilepsy in children with cerebral palsy can take many forms. Seizures are broadly classified as either focal, meaning they begin in one area of the brain, or generalized, meaning they involve widespread brain activity from the start.

Children with cerebral palsy may experience:

• Focal seizures, which may cause twitching, staring, or unusual sensations in one part of the body
• Generalized tonic-clonic seizures, which involve loss of consciousness, stiffening, and rhythmic jerking
• Absence seizures, brief lapses in awareness that may be mistaken for daydreaming
• Infantile spasms or other early-onset seizure types, particularly in children with severe cerebral palsy

Seizures often begin early in life. Research shows that as many as 69 percent of children with cerebral palsy and epilepsy have their first seizure before the age of one, especially those with more severe forms of the condition.

It is also important to note that seizures can sometimes be mistaken for involuntary movements related to CP, such as dystonia or spasticity. This is why expert evaluation by a pediatric neurologist is essential for accurate diagnosis.

How Epilepsy Is Diagnosed

Diagnosing epilepsy in a child with cerebral palsy involves a careful review of the child’s medical history, a detailed description of any unusual episodes, and specialized testing.

The primary diagnostic tool is an electroencephalogram, or EEG, which records electrical activity in the brain and can detect abnormal patterns associated with seizures. In some cases, prolonged video EEG monitoring may be used to capture events as they happen.

Brain imaging, typically with MRI, helps doctors understand the underlying brain injury and identify areas that may be contributing to seizures. This imaging can also guide decisions about treatment, particularly if surgical intervention is being considered.

Because movement disorders and seizures can sometimes look similar in children with cerebral palsy, neurologists take extra care to distinguish between the two. Video recordings provided by parents can be extremely helpful during this evaluation.

Treatment Options for Epilepsy in Cerebral Palsy

The first step in treating epilepsy is typically medication. Antiepileptic drugs, or AEDs, work by stabilizing electrical activity in the brain and reducing the frequency and severity of seizures.

Common medications used in children with cerebral palsy and epilepsy include levetiracetam, valproic acid, lamotrigine, and others. The choice of medication depends on the type of seizures, the child’s age, and other individual factors. Some children respond well to a single medication, while others require a combination of two or more drugs, a treatment approach known as polytherapy, which is more common in severe or complex epilepsy.

When seizures do not respond well to medication, a condition known as drug-resistant or medically intractable epilepsy, other treatment options may be considered. These include:

• The ketogenic diet, a high-fat, low-carbohydrate eating plan that has been shown to reduce seizures in some children
• Vagus nerve stimulation, a device implanted under the skin that sends electrical pulses to the brain
• Epilepsy surgery, such as the removal of a small area of damaged brain tissue or, in rare cases, a procedure called hemispherectomy

These advanced therapies are typically managed through specialized epilepsy centers and require careful evaluation to determine whether a child is a good candidate.

Seizure Control and Long-Term Outlook

Epilepsy is a lifelong condition for some children, but many do achieve good seizure control over time. Recent research suggests that approximately 45 to 54 percent of children with cerebral palsy and epilepsy eventually achieve remission, meaning they become seizure-free, often while continuing medication.

The chance of remission depends on several factors, including the type of cerebral palsy, the age at which seizures began, the number of different seizure types, and the presence of other medical or developmental conditions. Children with milder forms of cerebral palsy and fewer comorbidities generally have better outcomes.

Even when complete seizure freedom is not possible, many children experience significant improvement with treatment, allowing them to participate more fully in therapy, school, and daily life.

The Importance of Multidisciplinary Care

Managing epilepsy in a child with cerebral palsy requires more than just seizure control. These children often have complex medical, developmental, and therapy needs that are best addressed by a team of specialists.

A comprehensive care team may include:

• Pediatric neurologists with expertise in both cerebral palsy and epilepsy
• Developmental pediatricians who monitor growth, cognition, and overall health
• Physical, occupational, and speech therapists to support motor skills, communication, and feeding
• Nutritionists, especially if dietary therapies like the ketogenic diet are being used
• Social workers and care coordinators who help families navigate services and support systems

In New York, families have access to leading pediatric hospitals and epilepsy centers, including those at Mount Sinai, NYU Langone Health, Columbia University Irving Medical Center, and Albany Medical Center. These institutions offer specialized clinics, advanced diagnostic tools, and a comprehensive treatment options for children with cerebral palsy and epilepsy.

How Epilepsy Affects Daily Life and Development

Epilepsy can have a significant impact on a child’s quality of life. Seizures themselves may be frightening, unpredictable, and disruptive, and frequent seizures can interfere with learning, social interaction, and participation in therapies that are critical for children with cerebral palsy.

Medications, while necessary, can sometimes cause side effects such as drowsiness, irritability, or difficulty concentrating. Balancing seizure control with quality of life is an ongoing process that requires close communication between families and medical providers.

Safety is also an important consideration. Children with uncontrolled seizures may require supervision during activities such as bathing or swimming, and some may benefit from protective equipment such as helmets in certain situations.

Despite these challenges, many children with cerebral palsy and epilepsy lead meaningful, fulfilling lives. With appropriate care and support, they can reach their developmental potential and remain active participants in family and community life.

Finding Support and Resources in New York

Caring for a child with both cerebral palsy and epilepsy can feel overwhelming at times. Families should know that they are not alone and that support is available.

New York State offers a range of services for children with special health care needs, including Early Intervention for children under three and the state’s Care Coordination and Special Health Care Needs programs. Local school districts also provide special education services and related therapies.

National organizations such as the Epilepsy Foundation and United Cerebral Palsy provide educational resources, advocacy, and connections to local support groups. Many hospitals also offer family education programs and assistance with care planning.

At nybirthinjury.com, we are committed to helping families access trusted information and connect with qualified medical and support resources throughout New York and beyond. We understand that knowledge and connection can make a real difference in the lives of children and their caregivers.

Moving Forward with Confidence

Learning that your child has both cerebral palsy and epilepsy can be difficult, but advances in treatment and a deeper understanding of these conditions have significantly improved outcomes in recent years. With early diagnosis, expert medical care, and a strong support network, many children achieve meaningful seizure control and continue to make progress in their development.

If you have concerns about seizures or epilepsy in your child, talk to your pediatrician or pediatric neurologist. Early evaluation and treatment can make a meaningful difference in your child’s long-term health and quality of life.