Developmental trajectory and functional outcomes in children with epilepsy: a descriptive case series

Abstract

Early onset epilepsy has been reported in literature in as young as 2 years of age specially focusing on cognitive and executive function affection. However, effect of Epilepsy on physical function affection is under reported specially in children below 1 year of age. The objective here is to report a case series of 6 patients diagnosed with Epilepsy aged 9 months to 1.5 years at the time of their first visit to Physiotherapy OPD, with chief complaint of developmental delay/regression. This case series included six children diagnosed with Epilepsy and referred to Physiotherapy with the chief complaint of age-appropriate developmental delay in 4 children and regression in case of 2 children. Structural, genetic, and metabolic etiologies were confirmed with investigations in these children along with pre-epilepsy developmental milestone status through parent interview. Developmental status was examined before and after intervention using clinical assessment and Gross Motor Function Measure (GMFM) scores. Customised Physiotherapy intervention was given in accordance to structured short term goals. The baseline motor function ranged widely (GMFM 6%–52%). Early-onset epileptic encephalopathies demonstrated profound impairment, whereas non-progressive post-seizure cases showed moderate delay. Following intervention, five children demonstrated measurable GMFM improvement (19%-77.8%), most notably in trunk control, transitional movements, kneeling stability, and ambulation. Limited or negative progression was observed in children with progressive metabolic pathology. Thus, this case series provides the evidence for physical function affection in children with epilepsy under 1 year of age which improved substantially with neurophysiotherapy treatment.