Esma KELEŞ ALP, Kürşad AYDIN, Ayşe KARTAL

High rates of malnutrition and epilepsy: two common comorbidities in children with cerebral palsy

Background/aim: The aim of this study was to evaluate the nutritional status of children with cerebral palsy and determine the particularcharacteristics of the disorder.Materials and methods: The nutritional status of the children was assessed by the Gomez classification using weight-for-age. The GrossMotor Function Classification System was used to determine the gross and fine motor functions.Results: The study was conducted with 197 children (58.4% males) between the ages of 1 and 18 years old. Asphyxia (44.1%) was theprimary etiological factor, and spastic quadriplegia (41.6%) was the most common type of cerebral palsy. Malnutrition was the mostfrequent comorbidity and the overall malnutrition rate was 76.6%. The most common type of malnutrition was severe malnutrition,which was seen in 70 patients (35.5%). Epilepsy was the second most common comorbidity, seen in 51.7% of the cases.Conclusion: Our results revealed a high rate of malnutrition and epilepsy in children with cerebral palsy. These two more commonsignificant comorbidities that influence the outcomes of children with cerebral palsy should be carefully evaluated and successfullymanaged. Families of children with cerebral palsy and their physicians should be educated about the nutritional status in these children.

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1. SCPE Collaborative Group. Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Dev Med Child Neurol 2000; 42: 816-824.
2. SCPE. Prevalence and characteristics of children with cerebral palsy in Europe. Dev Med Child Neurol 2002; 44: 633-640.
3. Blair E, Watson L. Epidemiology of cerebral palsy. Semin Fetal Neonatal Med 2006; 1: 117-125
4. Blair E. Trends in cerebral palsy. Indian J Pediatr 2001; 68: 433- 438
5. Serdaroğlu A, Cansu A, Ozkan S, Tezcan S. Prevalence of cerebral palsy in Turkish children between the ages of 2 and 16 years. Dev Med Child Neurol 2006; 48: 413-416.
6. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, Dan B, Jacobsson B. A report: the definition and classification of CP April 2006. Dev Med Child Neurol 2007; 109: 8-14.
7. Kuperminc MN, Stevenson RD. Growth and nutrition disorders in children with cerebral palsy. Dev Disabil Res Rev 2008; 14: 137-146.
8. Campanozzi A, Capano G, Miele E, Romano A, Scuccimarra G, Del Giudice E, Strisciuglio C, Militerni R, Staiabo A. Impact of malnutrition on gastrointestinal disorders and gross motor abilities in children with cerebral palsy. Brain Dev 2007; 29: 25- 29.
9. Johnson A, Gambrah-Sampaney C, Khurana E, Baier J, Baranov E, Monokwane B, Bearden DR. Risk factors for malnutrition among children with cerebral palsy in Botswana. Pediatr Neurol 2017; 70: 50-55.
10. Scarpato E, Staiano A, Molteni M, Terrone G, Mazzocchi A, Agostoni C. Nutritional assessment and intervention in children with cerebral palsy: a practical approach. Int J Food Sci Nutr 2017; 68: 763-770.
11. Soylu OB, Unalp A, Uran N, Dizdarer G, Ozgonul FO, Conku A, Ataman H, Ozturk AA. Effect of nutritional support in children with spastic quadriplegia. Pediatr Neurol 2008; 39: 330-334.
12. Troughton KE, Hill AE. The relation between objectively measured feeding competence and nutrition in children with cerebral palsy. Dev Med Child Neurol 2001; 43: 187-190.
13. Singhi P, Saini AG. Changes in the clinical spectrum of cerebral palsy over two decades in North India – an analysis of 1212 cases. J Trop Pediatr 2013; 59: 434-440.
14. Joosten KF, Hulst JM. Prevalence of malnutrition in pediatric hospital patients. Curr Opin Pediatr 2008; 20: 590-596.
15. Oftedal S, Davies PS, Boyd RN, Stevenson RD, Ware RS, Keawutan P, Benfer KA, Bell KL. Longitudinal growth, diet, and physical activity in young children with cerebral palsy. Pediatrics 2016; 138: e20161321.
16. Singhi PD, Goraya J. Cerebral palsy. Indian J Pediatr 1998; 35: 37-48.
17. Bruck I, Antoniuk SA, Spessartite A, Bem RS, Hausberger R, Pacheco CG. Epilepsy in children with cerebral palsy. Arq Neuropsiquiatr 2001; 59: 35-39.
18. Gururaj AK, Sztriha L, Bener A, Dawodu A, Eapen V. Epilepsy in children with cerebral palsy. Seizure 2003; 12: 110-114.
19. Kulak W, Sobaniec W, Smigielska-Kuzia J, Kubas B, Walecki J. A comparison of spastic diplegic and tetraplegic cerebral palsy. Pediatr Neurol 2005; 32: 311-317.