Epilepsy in Children with Autistic Spectrum Disorder

Abstract

The comorbidity of autistic spectrum disorder (ASD) and epilepsy has been widely discussed but many questions still remain unanswered. The aim of this study was to establish the occurrence of epilepsy among children with ASD to define the type of epileptic seizures and syndromes, the age of onset of epilepsy, EEG abnormalities, the used antiepileptic drugs and the therapeutic responses for seizures and autistic behavior, as well as to find some correlations between epilepsy and gender, etiology and intellectual disability (ID). A retrospective study of medical files of 59 patients (aged 1–18 years) with ASD during a 5-year period was performed. ASD diagnosis was based on the DSM-5 diagnostic criteria. The patients were examined with a detailed medical history, physical and neurological examination, as well as some additional functional, imaging, laboratory and genetic investigations ASD etiology was syndromic in 9, probable syndromic in 9, and idiopathic in 41 children. ID was established in 90% of ASD children, and epilepsy in 44.4%. The onset of epilepsy prevailed before 7 years of age. The most common seizure types were focal with or without secondary generalization (53.4%). Focal epileptiform EEG abnormalities prevailed. Therapeutic response to seizures was good: 58% were seizure-free, while 27% had >50% seizure reduction but no improvement in autistic behavior. There was no correlation between epilepsy and either occurrence or degree of ID. There was a correlation between the frequency of epileptic seizures and the degree of ID. There was no significant difference among epilepsy rates in different etiologic, gender, and ID groups, probably because of the high percentage of ID and because this was a hospital-based study. Our study showed a significant percentage of epilepsy in ASD population and more than 1/4 were of symptomatic etiology. Those could be managed with specific treatments based on the pathophysiology of the gene defect.

Autism medical comorbidities

“…Therefore, autism is considered as a comorbidity to epilepsy, and epilepsy is considered as a comorbidity to autism. Both may occur together[ 19 ]. Severity of seizure activity varies from grand mal to subtle activities such as rapid eye blinking, zoning out, inattention for prolonged periods; with/without disturbed consciousness or even epileptic encephalopathies.…”

Autism Spectrum Disorder (ASD) in a Developing country. A Clinical and Descriptive Study of 75 Infant and Young Patients

“…Loussouarn et al [65] emphasized the high prevalence of EEG abnormalities in children with ASD without epilepsy, and that EEG should only be performed at epilepsy onset, and more precisely when a clinical interview has confirmed that repetitive paroxysmal events could be seizures. Pacheva et al [66] postulate that in the occurrence of epilepsy among children with ASD we should define the type of epileptic seizures and syndromes, the age of onset of epilepsy, EEG abnormalities, the used antiepileptic drugs and the therapeutic responses for seizures and autistic behavior, as well as to find some correlations between epilepsy and gender, etiology and intellectual disability (ID).…”

Zaburzenia ze spektrum autyzmu i padaczka

“…In many works, common pathophysiological mechanisms have been shown to underlie both of these diseases Appearance of both could be determined by structural abnormalities in CNS, genetic and environmental factors, metabolic disorders or perinatal injuries. Key words: epilepsy, autism, ASD, intellectual disability, EEG Zaburzenia ze spektrum autyzmu (autistic spectrum disorders ASD) to coraz częściej rozpoznawane biologiczne zaburzenia neurorozwojowe charakteryzujące się upośledzeniem komunikacji i interakcji społecznych oraz stereotypowością zachowań i zainteresowań, występują u 0,75% do 1,1% populacji [1,2]. Padaczka z różnymi rodzajami napadów pojawia się u około 0,4% do 0,8% populacji [3].…”

“…[6] 2,7%-44,4% Buckley i Holmes [7] 5%-46% Pacheva i wsp. [2] 15,2% Matsuo i wsp. [8] 5%-37% Berg i Plioplys [5] 8,6% Thomas i wsp.…”