Abstract

BackgroundThere is conflicting data as to the prevalence of seizures and the relevance of epileptiform EEGs in autistic children. With the focus primarily on aetiology in autism research, very little emphasis has been placed on comorbid conditions in recent years. This imbalance must be brought to attention, as the comorbidities may harbour the prospect for effective treatment options.ObjectivesTo determine the prevalence and characteristics of seizures in autistic children and to develop a clinical profile of the autistic child with seizures.MethodClinical, EEG, and MRI data of 86 autistic children between the ages of 3 and 13 years old, spanning a 10-year period, from 1 January 2008 until 1 January 2018, were analysed retrospectively.ResultsThe prevalence of epilepsy was 23% with a 95% confidence interval (14.8, 33.6). There were 17 males and 3 females. There was no correlation with a history of regression and sleep hygiene.ConclusionSeizures are common in autistic children (23%) and have a much higher prevalence than in the general childhood population (0.5–1.0%). Semiology can be subtle, mimicking autistic behaviour. EEG and MRI evidence is often lacking, making the diagnosis of epilepsy difficult. If left unrestrained, the seizures frequently evolve into intractable epilepsy. Greater awareness is imperative in order to prevent early cognitive and behavioural decline. This is one of only a few such studies to have come out of Africa. More studies from different geographical locations are urgently required.

Highlights

  • Autism has reached epidemic proportions, and there is no obvious explanation for this increase [1]

  • This is to the detriment of the child with autism, as some of these conditions may be preventable to a certain degree, or at least harbour valid targets for current treatment options

  • Of great interest is that comorbidities such as cognitive impairment and epilepsy may share a common and dysfunctional neurobiological substrate with autism, leading to the possibility that improvement in one domain may result in more widespread benefit in neurodevelopment

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Summary

Introduction

Autism has reached epidemic proportions, and there is no obvious explanation for this increase [1]. Of great interest is that comorbidities such as cognitive impairment and epilepsy may share a common and dysfunctional neurobiological substrate with autism, leading to the possibility that improvement in one domain may result in more widespread benefit in neurodevelopment. In order for this to happen, certain circuits must be shared by the respective conditions. With the focus primarily on aetiology in autism research, very little emphasis has been placed on comorbid conditions in recent years This imbalance must be brought to attention, as the comorbidities may harbour the prospect for effective treatment options

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