The Role of Epilepsy in ASD

Background:  The association of Autism Spectrum Disorders (ASD)  with epilepsy is well recognized. The rate of comorbidity is still uncertain but a  conservative estimate is 20-25% of ASD patients suffer from seizures. Epileptiform abnormalities without seizures are as frequent as 20-30% in this population however  their role in the development of the nuclear disturbances of autism is controversial as it is the role of epilepsy itself. The relationship of ASD with epilepsy  is unclear and needs more research

Objectives:  Aim of the study was  to determine the prevalence and the longitudinal outcome  of epilepsy in a group of children with Autism (ASD) and  to describe the clinical course over time

Methods:  A 10 years follow up study of epilepsy in ASD is herein presented. Patients: 129 children and adolescents with ASD,  103 Males;  26 Females;  15.5  ys  mean age,  SD +/- 3.9 (mean Age at baseline =7.8). DSM-IV diagnosis: Autistic Disorder n=113, Pervasive Developmental Disorder-NOS n=15; Asperger disorder n=1

Results:   Epilepsy at baseline n=18/129 (14%); 12 Males and 6 Females. Epi and Epileptiform abnormalities(EA) were detected in n=11/18 (8.5%) Epileptiform abnormalities without seizures in n=40/129 (31%); 25 Males and 15 Females. At follow up epilepsy was still present in  n=14/129  with a decrease  from 14% to 11% (p<0.01) males and 4 females with a ratio of 2.2:1. Epileptiform abnormalities were observed n=20/129     from 31% to 15.5% (p<0.001); 10 males and 10 females  1:1. Epilepsy with EA n=7    from 8.5% to 3.5%

Conclusions: The course of seizures over  time in this group of patients with ASD was characterized bur a mild decrease of prevalence of epilepsy and a more significant reduction of EA without seizures. AED treatmenht is possibly implicated in such an outcome. The influence of epilepsy on ASD core symptoms  was of secondary importance as to the overall evolution.