Autistic regression and disintegrative disorder: how important the role of epilepsy?
At least a third of autistic toddlers regress in language, sociability, play, and often cognition. Many fewer children undergo a similar, unexplained regression after language is fully developed (disintegrative disorder [DD]). Epilepsy or a paroxysmal electroencephalogram (EEG) with/without clinical seizures, including electrical status epilepticus in slow wave sleep (ESES), may be associated, in occasional children, with either selective loss of language (Landau-Kleffner syndrome [LKS]) or with pervasive autistic regression. Fluctuation in language and behavior deficits should raise the suspicion of epilepsy. Review of the literature and of the author's experience suggests that epilepsy probably plays a relatively minor, although non-negligible, pathogenetic role in autistic regression. Multidisciplinary, possibly multi-institutional, longitudinal studies that encompass the regression are needed to sharpen diagnostic criteria to devise more effective therapies.
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Saul R. Korey Department of Neurology, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA.
D001321:Autistic Disorder / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D002658:Developmental Disabilities / Q000209:etiology*; D018450:Disease Progression; D004569:Electroencephalography; D004827:Epilepsy / Q000150:complications*; D006801:Humans; D007223:Infant; D018887:Landau-Kleffner Syndrome / Q000150:complications; D007806:Language Disorders / Q000209:etiology*; D012894:Sleep Stages / Q000502:physiology; D012893:Sleep Wake Disorders / Q000150:complications; D013226:Status Epilepticus / Q000150:complications; D009626:Terminology as Topic