Childhood Epilepsy and Autism Spectrum Disorders: Psychiatric Problems, Phenotypic Expression, and Anticonvulsants

Abstract

Epilepsy and autism spectrum disorders (ASDs) frequently co-occur during childhood, however, the characteristics of psychiatric or behavioural problems in these children remains largely unknown. This article contributes to these discussions by reporting on the prevalence and presentation of psychiatric or behavioural problems in children with epilepsy and ASDs, as well as on the use of anticonvulsants in these children. The current evidence suggests that children with epilepsy and ASDs may present with a distinct clinical profile, with a greater number of developmental difficulties, and a more severe expression of the ASD phenotype that can not solely be accounted for by level of intellectual functioning. Positive effects of anticonvulsants on behavioural symptoms associated with ASDs were also reported, though pharmacoresistance and a lack of clear treatment guidelines may contribute to an elevated risk of adverse side effects. In relation to clinical presentation and management there is a need for careful consideration of potential interaction effects between disorder specific factors (e.g., age of seizure onset/ASD diagnosis), cognitive characteristics (e.g., intellectual functioning, memory), and psychosocial variables (e.g., coping strategies). Ultimately however, many conclusions are tentative and this review highlights the need for more empirically validated research on children with epilepsy and ASDs.

Autistic-Like Syndrome in Mu Opioid Receptor Null Mice is Relieved by Facilitated mGluR4 Activity

“…Finally, numerous autistic patients suffer from increased susceptibility to seizures (Robinson, 2012). In agreement with earlier studies showing lowered seizure thresholds in response to several convulsant drugs in Oprm1 À / À mice (Grecksch et al, 2004;Jang et al, 2001), we found that pentylenetetrazole (37.5 and 50 mg/kg) induced more severe convulsions in mutants as compared with Oprm1 þ / þ animals (37.5 mg: H 1,20 ¼ 11.6, po0.001; 50 mg: H 1,20 ¼ 10.0, po0.01; no gender effect) (Figure 2h and Supplementary Figure S2e).…”

“…Secondary-comorbid-symptoms vary substantially and include anxiety disorders, cognitive and motor deficits, aggressive behavior, and epileptic episodes (Johnson and Myers, 2007;Mazurek et al, 2013;Pouw et al, 2013;Robinson, 2012;Veenstra-VanderWeele and Blakely, 2012;White et al, 2012;Whyatt and Craig, 2013). Heterogeneity in ASDs points toward multiple primary causes, with genetic factors playing a critical role.…”

Roles of Rac1 and Rac3 GTPases during the development of cortical and hippocampal GABAergic interneurons

“…Whether this phenotype corresponds to a defect of the inhibitory networks in the Rac3KO mice remains to be established. If so, this will open the possibility to explore the molecular machinery linked to Rac function and underlying the hyperactive/impulsive behavior, phenotypes observed in different neurologic and psychiatric disorders such as ADHD, epilepsy, and autistic disorders (Robinson, 2012; Pincham, 2014). …”

Omega-3 polyunsaturated fatty acids in large doses attenuate seizures, cognitive impairment, and hippocampal oxidative DNA damage in young kindled rats

“…Epilepsy in children is often accompanied by cognitive disorders, such as spatial memory deficits and impaired emotional learning [1]. The damaging effects of seizures on cognition have been extensively studied in various rodent-kindling models [2].…”