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Cerebral palsy (CP) affects between 2 and 3 per 1000 live births and is thought to be the most common cause of serious physical disability in childhood. A widely used topographical classification of CP has been formulated by the Surveillance of Cerebral Palsy in Europe group. This divides CP into spastic, dyskinetic, and ataxic subtypes. Children with CP due to central nervous system (CNS) malformation, infection, and gray matter damage were more likely to have epilepsy than those with CP due to white matter damage. The predominant type is focal seizures or focal seizures evolving into secondary generalized tonic-clonic (GTC) seizures. The majority of CP etiologies can be established based on a detailed history, examination, and neuroimaging without the need for other investigations. Magnetic resonance imaging (MRI) is the imaging modality of choice. Epilepsy surgery can have a good outcome particularly for children with hemiplegia.
This chapter discusses the demographic data, pathological characteristics and pathophysiological mechanisms of epilepsy in Cavernous malformations (CMs). It presents genetic aspects, clinical features, diagnostic tools and therapeutic options for CMs. CMs are characterized by low-flow sinusoidal vessels lined by thin endothelial walls with no obvious feeding arteries or venous drainage. For an optimal therapeutic approach it is mandatory to understand the epilepsy inducing mechanisms associated with CMs. Numerous studies of magnetoencephalography (MEG) in medically intractable epilepsy have shown that MEG can detect interictal and ictal epileptiform activity. The role in diagnosis and the history of imaging techniques such as cerebral angiography, computed tomography (CT), and magnetic resonance imaging (MRI) as well as the radiological characteristics of CM have been extensively reviewed in recent literature. The optimal management of CMs presenting with epileptic seizures is still a matter of debate.