Tracking epilepsy and autism

Abstract

BACKGROUND : There is conflicting data as to the prevalence of seizures and the relevance of epileptiform EEGs in autistic children. With the focus primarily on aetiology in autism research, very little emphasis has been placed on comorbid conditions in recent years. This imbalance must be brought to attention, as the comorbidities may harbour the prospect for effective treatment options. OBJECTIVES : To determine the prevalence and characteristics of seizures in autistic children and to develop a clinical profile of the autistic child with seizures. METHOD : Clinical, EEG, and MRI data of 86 autistic children between the ages of 3 and 13 years old, spanning a 10-year period, from 1 January 2008 until 1 January 2018, were analysed retrospectively. RESULTS : The prevalence of epilepsy was 23% with a 95% confidence interval (14.8, 33.6). There were 17 males and 3 females. There was no correlation with a history of regression and sleep hygiene. CONCLUSION : Seizures are common in autistic children (23%) and have a much higher prevalence than in the general childhood population (0.5–1.0%). Semiology can be subtle, mimicking autistic behaviour. EEG and MRI evidence is often lacking, making the diagnosis of epilepsy difficult. If left unrestrained, the seizures frequently evolve into intractable epilepsy. Greater awareness is imperative in order to prevent early cognitive and behavioural decline. This is one of only a few such studies to have come out of Africa. More studies from different geographical locations are urgently required.