Abstract
It has been reported that bioelectric alterations in an electroencephalogram (EEG) may play an etiological role in neurodevelopmental disorders. The clinical impact of interictal epileptiform discharges (IEDs) in association with autistic spectrum disorder (ASD) is unknown. The Autism Diagnostic Interview-Revised (ADI-R) is one of the gold standards for the diagnosis of autistic spectrum disorder. Some studies have indicated high comorbidity of IED and ASD, while other studies have not supported an association between the central symptoms of autism and IED. This review examines the high comorbidity and clinical impact of IED; patients with epilepsy are excluded from the scope of this review. ASD can be disabling and is diagnosed at an average age of 5 years old, at which point the greatest neurological development has occurred. If an association between IED and ASD is identified, a clinical tool that entails an innocuous procedure could enable diagnosis in the first years of life. However, in the absence of reports that prove an association between IED and ASD, patients should not be subjected to expensive treatments, such as the administration of anticonvulsant therapies.
Highlights
Autism spectrum disorder (ASD) is a condition with different clinical manifestations that are expressed as a common clinical phenotype
Some children with autism may show DEI in their EEG that never manifests as seizures [8,9,10,11]. These data imply that early detection of interictal epileptiform discharges (IEDs) would not affect the eventual development of epilepsy, but if we consider that the average prevalence of epilepsy in ASD doubles in adolescence [12], it is prudent to closely monitor ASD patients at this stage of their lives
Clinicians must bear in mind that, at present, there are data that do support the existence of an association between IEDs and ASD or Autism Diagnostic Interview-Revised (ADI-R) domains [75], and these studies label it as an epiphenomenon [30]
Summary
Autism spectrum disorder (ASD) is a condition with different clinical manifestations that are expressed as a common clinical phenotype. Some children with autism may show DEI in their EEG that never manifests as seizures [8,9,10,11] These data imply that early detection of IED would not affect the eventual development of epilepsy, but if we consider that the average prevalence of epilepsy in ASD doubles in adolescence [12], it is prudent to closely monitor ASD patients at this stage of their lives. It is important to determine whether an association exists between IED and ASD: if so, we will have an element that would facilitate early diagnosis of ASD If such an association does not exist, patients will not be subjected to anticonvulsant treatment
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