Absence of seizures despite high prevalence of epileptiform EEG abnormalities in children with autism monitored in a tertiary care center.
OBJECTIVE
Children with autism are commonly referred for video-EEG monitoring to determine the precise nature of their seizure-like events.


METHODS
We studied 32 children with autism by using continuous video-EEG telemetry (VEEG) monitoring at a tertiary care referral center.


RESULTS
Of the 32 total patients, 22 were primarily referred for seizure evaluation and 10 for 24-h interictal EEG recording. Studies in two additional patients were prematurely terminated because of intolerance (they are not included in the analyses). The median monitoring duration was 1 day (range, 1-7 days). Of 22 patients referred for seizure evaluation, 15 had recorded events, but none was an epileptic seizure; the other seven patients had no recorded events. Interictal epileptiform EEG abnormalities were detected in 19 (59%) of 32 patients. These abnormalities included focal sharp waves (in eight patients), multifocal sharp waves (in six patients), generalized spike-wave complexes (in 11 patients), and generalized paroxysmal fast activity/polyspikes (in two patients). Focal/multifocal and generalized epileptiform abnormalities coexisted in six patients. Notably, 11 (73%) of the 15 patients with nonepileptic events had interictal epileptiform EEG abnormalities.


CONCLUSIONS
Video-EEG evaluation of children with autism reveals epileptiform EEG abnormalities in the majority. However, many recorded seizure-like events are not epileptic, even in children with epileptiform EEG abnormalities.
Kim
Howard L
HL
Department of Neurology, University of California at Irvine College of Medicine, UCI Medical Center, 101 The City Drive, Orange, CA 92868, U.S.A. kimhl@uci.edu
Donnelly
Joseph H
JH
Tournay
Anne E
AE
Book
Teri M
TM
Filipek
Pauline
P
D000293:Adolescent; D001321:Autistic Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D002140:California / Q000453:epidemiology; D002540:Cerebral Cortex / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000379:methods / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D013686:Telemetry / Q000379:methods / Q000706:statistics & numerical data; D014743:Videotape Recording