Abstract
BackgroundDespite the high prevalence of seizure, epilepsy and abnormal electroencephalograms in individuals with autism spectrum disorder (ASD), there is little information regarding the relative effectiveness of treatments for seizures in the ASD population. In order to determine the effectiveness of traditional and non-traditional treatments for improving seizures and influencing other clinical factor relevant to ASD, we developed a comprehensive on-line seizure survey.MethodsAnnouncements (by email and websites) by ASD support groups asked parents of children with ASD to complete the on-line surveys. Survey responders choose one of two surveys to complete: a survey about treatments for individuals with ASD and clinical or subclinical seizures or abnormal electroencephalograms, or a control survey for individuals with ASD without clinical or subclinical seizures or abnormal electroencephalograms. Survey responders rated the perceived effect of traditional antiepileptic drug (AED), non-AED seizure treatments and non-traditional ASD treatments on seizures and other clinical factors (sleep, communication, behavior, attention and mood), and listed up to three treatment side effects.ResultsResponses were obtained concerning 733 children with seizures and 290 controls. In general, AEDs were perceived to improve seizures but worsened other clinical factors for children with clinical seizure. Valproic acid, lamotrigine, levetiracetam and ethosuximide were perceived to improve seizures the most and worsen other clinical factors the least out of all AEDs in children with clinical seizures. Traditional non-AED seizure and non-traditional treatments, as a group, were perceived to improve other clinical factors and seizures but the perceived improvement in seizures was significantly less than that reported for AEDs. Certain traditional non-AED treatments, particularly the ketogenic diet, were perceived to improve both seizures and other clinical factors.For ASD individuals with reported subclinical seizures, other clinical factors were reported to be worsened by AEDs and improved by non-AED traditional seizure and non-traditional treatments.The rate of side effects was reportedly higher for AEDs compared to traditional non-AED treatments.ConclusionAlthough this survey-based method only provides information regarding parental perceptions of effectiveness, this information may be helpful for selecting seizure treatments in individuals with ASD.
Highlights
Despite the high prevalence of seizure, epilepsy and abnormal electroencephalograms in individuals with autism spectrum disorder (ASD), there is little information regarding the relative effectiveness of treatments for seizures in the ASD population
Despite the high prevalence of seizure, epilepsy and abnormal EEGs in individuals with ASD, there is little information regarding the relative effectiveness of treatments for epilepsy, seizure or subclinical epileptiform discharges in this population
To shed light on the ability of treatments used in ASD to affect seizures and other important clinical characteristics associated with ASD, we developed an on-line seizure survey to investigate parental perceptions about the effect of treatments for their children with ASD on seizures
Summary
Despite the high prevalence of seizure, epilepsy and abnormal electroencephalograms in individuals with autism spectrum disorder (ASD), there is little information regarding the relative effectiveness of treatments for seizures in the ASD population. The Despite the high prevalence of seizure, epilepsy and abnormal EEGs in individuals with ASD, there is little information regarding the relative effectiveness of treatments for epilepsy, seizure or subclinical epileptiform discharges in this population. ASD is associated with cortical hyperexcitability, potentially due to deficits in cortical inhibitory circuits [5] This suggests that AEDs that enhance gamma-aminobutyric acid pathways might be relatively better treatments for individuals with ASD. Since individuals with ASD already have problems with attention, mood and cognition, prescribing an AED with such adverse effects might result in poor overall function even if seizures are controlled.
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