Background: Outcome and clinical course are not well defined in Cerebral palsy (CP) patients .The aim of the present study was to investigate the clinical course and outcome of symptomatic epilepsy in CP patients and identify variables determining the long-term prognosis.

Methods: We retrospectively followed 107 CP patients with newly diagnosed epilepsy aged 1–16 years old. Patients were categorized according to their remission outcome  (uninterrupted seizure freedom lasting 2 years or longer) and 4 prognostic patterns: A) early and sustained seizure freedom; B) delayed but sustained seizure freedom; C) fluctuation between periods of seizure freedom and relapse; and D)seizure freedom never attained. Variables were analyzed for their prognostic relevance towards the outcome of the patients.

Results: Included were 107 patients, mean age of epilepsy diagnosis 4.2 years (SD 2.5). By the end of 8 years follow up, 19.6% were in sustained remission, 26.1% in terminal remission , 31.7% in relapse, and 22.4 % in the no remission category. 7 patients responded to AEDs in the first six months of treatment and maintained their response through follow up (pattern A), 29 patients needed more than six months to respond and maintained their response (pattern B), 47 patients had relapsing remitting course, and 24 patients never had 1 year free of seizure.

Conclusions: The long-term prognosis is not favourable in most cases, Early seizure remission is not invariably followed by terminal remission and seizure outcome varies according to well-defined patterns. Further larger studies are required to delineate other prognostic factors.