Epilepsy and EEG paroxysmal abnormalities in autism spectrum disorders.
The occurrence of epilepsy in autism is variable; nevertheless, EEG paroxysmal abnormalities (PA) are frequently recorded in patients with autism, although the influence of epilepsy and/or EEG PA on the autistic regression has not been clarified yet. We examine a large sample of 345 inpatients with autism, divided into three groups: (1) patients without epilepsy and EEG PA; (2) patients with EEG PA but no seizures; (3) patients with epilepsy including febrile convulsions. The prevalence of epilepsy (24.9%) and EEG PA (45.5%) was higher than that reported in the general population. The significant differences among the three groups concerned autistic regression (comparison between groups 1 and 2, p<0.05; comparison between groups 1 and 3, p<0.01), cerebral lesions (comparison between groups 1 and 2, p<0.05; between groups 1 and 3, p<0.001), and symptomatic autism (comparison between groups 1 and 2 as much as comparison between groups 1 and 3, p<0.001), which were prevalent in groups 2 and 3; while severe/profound mental retardation was more frequent in group 3 compared to group 1 (p<0.01). Focal epilepsy (43.0%) and febrile convulsions (33.7%) were frequent in the third group with epilepsy. EEG PA were mainly localized in temporal and central areas (31.4%). Only 2.6% of patients had subcontinuous/continuous EEG PA during sleep. Seizures and EEG PA were not related to autistic regression. EEG PA occurred mainly in childhood, while epilepsy tended to occur (p<0.001) as age increased. The age at onset of seizures had two peaks: between 0 and 5 and between 10 and 15 years with no difference between idiopathic and symptomatic cases. In 58.5% of subjects aged > or = 20 years, epilepsy including febrile seizures occurred at some point of their lives, while cases with only EEG PA were less frequent (9.7%). The relationship among autism, EEG PA and epilepsy should be clarified and investigated. In autism, seizures and EEG PA could represent an epiphenomenon of a cerebral dysfunction independent of apparent lesions.
Parmeggiani
Antonia
A
Autism Centre, Child Neurology and Psychiatry Unit, Department of Neurological Sciences, University of Bologna, Italy. antonia.parmeggiani@unibo.it
Barcia
Giulia
G
Posar
Annio
A
Raimondi
Elena
E
Santucci
Margherita
M
Scaduto
Maria Cristina
MC
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001921:Brain / Q000503:physiopathology*; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000150:complications*; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D055815:Young Adult