The prevalence of autistic spectrum disorder in children surveyed in a tertiary care epilepsy clinic.
It is well documented that children with autistic spectrum disorder (ASD) have an increased prevalence of seizures; however, studies have not been done to evaluate the prevalence of ASD in children with epilepsy. This comorbidity is important to define as early diagnosis and intervention in some children with ASD has been shown to improve outcome.


METHODS
Children with epilepsy seen in a tertiary care epilepsy clinic were evaluated using validated autism screening questionnaires (ASQ). In addition, questions about sleep-related disorders, behavior, seizure characteristics, antiepileptic agents, and body mass index (BMI) were requested. An attempt was then made to determine if there was a correlation between the factors identified and ASD.


RESULTS
Of the 107 questionnaires returned, 97 ASQ's were properly completed and used in this study. Approximately 32% of children fit the ASQ criteria for having ASD. Most children had not been previously diagnosed. Worst behavior and daytime sleepiness was seen in those at greater risk (p < 0.01). Seizures also occurred earlier (approximately 2 years) in children at risk of having ASD.


CONCLUSIONS
Though confirmatory diagnostic evaluations are needed, this questionnaire-based study suggests that children with epilepsy are at greater risk of having ASD, and illustrates the need for more clinical vigilance. Behavioral difficulties and daytime sleepiness identified in these children could potentially affect their ability to learn. It is of interest that the age of seizure onset identified in those at greater risk corresponds with the approximate age of regression identified in some children with ASD.
Clarke
Dave F
DF
Department of Pediatrics, Division of Neurology, Le Bonheur, University of Tennessee Health Science Center Comprehensive Epilepsy Program, Memphis, Tennessee 38105, USA. dclarke3@utmem.edu
Roberts
Wendy
W
Daraksan
Mina
M
Dupuis
Annie
A
McCabe
Jane
J
Wood
Halyey
H
Snead
O Carter
OC
Weiss
Shelly K
SK
D000293:Adolescent; D017668:Age of Onset; D000927:Anticonvulsants / Q000627:therapeutic use; D001321:Autistic Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D015992:Body Mass Index; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D002675:Child, Preschool; D015897:Comorbidity; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening; D010290:Parents / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D012043:Regression, Psychology; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology; D011795:Surveys and Questionnaires
D000927:Anticonvulsants