Seizures and Autism Spectrum Disorder

Seizures occur more frequently in individuals on the autism spectrum than in other children. Many of the neurological syndromes and structural causes of epilepsyalso lead to developmentalchallenges that fulfill criteria for autism spectrum disorder(ASD), and increasingly there is evidence of geneticabnormalities such as microdeletions and duplications that affect brain development and lead to both epilepsyand autism. Although doctors and researchers do not always understand why ASD and epilepsyco-occur, treatmentaims to manage the overlapping cognitive, language, affective, social, and behavioral delays common to both disorders.

A seizureis an abnormal electrical discharge in the brain altering function or behavior. It is the most common neurological condition in children, with a prevalenceof more than 4%. Epilepsy, defined as two or more unprovoked seizures, occurs in 2-3% of the general population. Remarkably, epilepsyis reported in 25-40% of individuals on the autism spectrum. Identified risk factors for epilepsyin those with on the spectrum include intellectual disability, an underlying neurologicdisorder, a family history of epilepsy, and severe cognitivedelay.

Most cases of epilepsyin children on the autism spectrum present after 10 years of age, and all seizuretypes have been reported. Seizures may be focal (partial), with only one side of the brain involved, or generalized in which both sides of the brain display abnormal activity. Focal seizures are further classified as either simple (no altered level of consciousness) or complex (altered level of consciousness). Generalized seizures may be either convulsive or non-convulsive. An electroencephalogram(EEG) is the diagnostic test that measures electrical activity in the brain and is used to confirm a clinical suspicion of seizureactivity.

Symptoms of seizures are widely variable but include stiffening (tonic) or rhythmic twitching (clonic) of one or more extremities or the face, staring spells, lip smacking or other non-purposeful movements or distinct periods of changes in behavior such as staring or sudden headache. In children on the autism spectrum, a sudden loss of languageskills or behavioral regressionmay be caused by epileptic disruption of organized brain activity that may not always show up clinically. (This is called electrical status epilepticus of sleep.)

Seizuretype, EEG findings, and clinical factors dictate treatmentof epilepsyin those who are on the autism spectrum and those who are not. The goal of medicationwith anti-epileptic drugs is to eliminate all seizures without negatively impacting cognitiveand behavioral functioning.

Watch And Listen To Dr. Eron Friedlaender Discuss Medical Aspects Of Autism Spectrum Disorder