The Incidence of Epileptic Seizures and/ or Epileptiform EEG Abnormaliti es in Children with Childhood and Atypical Autism

Czech version

Authors: H. Ošlejšková ¹; L. Dušek ²; Z. Makovská ¹; E. Dujíčková ¹; R. Autrata ³; I. Šlapák ⁴
Authors‘ workplace: Klinika dětské ne urologi e LF MU a FN Brno, Centrum pro epileptologii a epileptochirurgii MU Brno ¹; Centrum bi ostatistiky a analýz LF MU ²; Dětská oční klinika LF MU a FN Brno ³; Klinika dětské ORL LF MU a FN Brno ⁴
Published in: Cesk Slov Neurol N 2008; 71/104(4): 435-444
Category: Original Paper

Overview

In more than 40% of a utistic spectrum disorders (ASD) cases are associ ated with epileptic seizures and, in up to 20%, with epileptiform abnormaliti es in EEG witho ut clinical epileptic seizures. Our study is a retrospective evaluati on of 205 children (145 boys, 60 girls) with ASD aged 10 (and also 5 and 15) years. Signs of an epileptic process (epileptic seizures and/ or epileptiform activity in EEG) were seen in 103 cases (50.2%), epileptic seizures with/ witho ut epileptiform abnormaliti es in the EEG occurred in 64 children (31.2%), and epileptic seizures witho ut epileptiform EEG abnormaliti es occurred in 5 cases (2.4%). Coincidence of signs of an epileptic process and an ASD increased most typically in a subgro up of pati ents with childhood a utism (CA 66.0%) and atypical a utism (AA 30.1%). It was rare in children with Asperger’s syndrome (AS) (N = 4, i.e. 3.9% o ut of total set N = 103 and 19.1% within AS) and above average in a utism with regressi on (41.8%). The most frequent forms of epileptic activity were parti al seizures (46.6%), of these 27.2% were complex parti al seizures and 19.4% simple parti al seizures. Generalized seizures appeared in 29.1%. Of these atonic generalized seizures were present in 11.7%, and infantile spasms in 10.8%. Among the epileptic syndromes (epilepsi es), the most frequently occurring type were parti al seizures – 30.1%, and generalized seizures – 23.3%. Speci al epileptic syndromes (continuo us discharges in slow sleep „CSWS“ and Landa u- Kleffner syndrome) occurred in 3.9%. In o ur study gro up, epilepsy was significantly associ ated with multiple other pathological findings such as abnormal ne urological clinical examinati ons, EEG abnormaliti es (abnormal backgro und, non- specific abnormaliti es), pathological findings on CT and/ or MRI, decreased frequency of right- handed children in the family history. It significantly decreases IQ. The most common types of seizures and epilepsi es and the significant associ ati on between them and abnormal ne urological findings, pathological CT and MRI findings, and abnormal basic activity in ECG points to the fact that o ur study gro up included mainly children with encephalopathy and secondary a utism. In pati ents with epileptic seizures the occurrence of seizures substanti ally predates the age of onset of the first symptoms of a utism recognized by the parents. This informati on concerns a utism with low and mean functi onality, on the contrary, the opposite trend is evident in pati ents with high functi onality. This result does not, however, mean that low and mean functi onality a utism is a result of epilepsy in children.

Key words:
a utism – secondary a utism – epileptic seizures – epileptiform abnormaliti es on EEG – a utism with regressi on – Asperger‘s syndrome – Intelligence Quoti ent – Childhood Autism Rating Scale

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