Autism spectrum disorders in children with active epilepsy and learning disability: comorbidity, pre- and perinatal background, and seizure characteristics

Abstract

The aim of this study was to examine the comorbidity pattern, seizure characteristics, and aetiology in a representative group of children with a combination of autism spectrum disorder (ASD), active epilepsy, and learning disability. Ninety children (47 males, 43 females; mean age 11 years 2 months, range 8 to 16 years at the time of psychiatric examination) with active epilepsy and learning disability, identified in a population-based study in Göteborg, Sweden, were subdivided into those with and those without ASD and compared with respect to aetiology, additional neuroimpairments, and seizure characteristics. In addition, the cohorts were examined for trends of prevalence over a period of time. Results indicated that established aetiology was much more often present in the prenatal period than in the peri- or postnatal periods in the ASD group. Cerebral palsy and visual impairment were under-represented in the ASD group. Partial seizures tended to be more common and generalized seizures less common in the ASD group compared with the non-ASD group. Seizure onset was later in the ASD group. Many of the significant differences were accounted for by a large group of psychiatrically unclassifiable participants in the non-ASD group. There was no trend towards an increase of affected children over the 12-year period. There was no increase in the prevalence of active epilepsy and learning disability nor in the rate of autism with active epilepsy and learning disability in children born between 1981 and 1986 compared with those born from 1976 to 1980, indicating no statistical association with the general measles-mumps-rubella vaccination introduced in the early 1980s.

Epilepsy in Patients With Pervasive Developmental Disorder Not Otherwise Specified

“…17 Seizure semiology and type of epilepsy were not reported in PDDNOS, whereas they were described in autistic disorder and autistic-like conditions, which in fact are different clinical entities. [10][11][12]23 The higher occurrence of epilepsy in our sample of patients with PDDNOS (35.1%) corresponds to the value range described for pervasive developmental disorders 10,11 but is greater than the epilepsy occurrence in patients with PDDNOS reported in literature (5.6% to 30.1%). [15][16][17] In contrast, no significant differences have been reported for autistic disorder.…”

Early diagnosis of autism and impact on prognosis: a narrative review

“…The disorders co-occur in about 30% of individuals with either ASD or epilepsy and there is a strong association between ID, autism, and epilepsy 50. Some authors have suggested specific peaks of seizure onset in children with autism: in early childhood and in adolescence, and also with continuing risks through adulthood 50. However, such peaks have not been supported in prospective longitudinal population-based studies of epilepsy in autism 121…”

One‐third of school‐aged children with cerebral palsy have neuropsychiatric impairments in a population‐based study

“…Behaviour problems are also common in children with CP , including neuropsychiatric disorders such as autism spectrum disorder (ASD) and attention‐deficit/hyperactivity disorder (ADHD). During the last decade, there has been growing awareness particularly of ASD being overrepresented in children with CP, reported from 3% to 16% , depending on the group studied and the methods used. In a European multicentre CP study by Delobel‐Ayoub et al, male sex, epilepsy, ID and better walking ability were associated with ASD in children with CP .…”