Seizure Disorders & Autism

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Children with ADHD had a 2.5-fold increased risk for unprovoked seizures. The association was significant for ADHD predominantly inattentive type.
Reuters Health Information
Seizures can be debilitating across a number of physical, social, occupational, and personal variables. Given the deficits in all of these areas frequently present in persons with mental retardation, effective assessment and subsequent treatment of seizures is a primary goal for individuals with both mental retardation and epilepsy. To thoroughly address the behavioral domains related to seizures in persons with mental retardation and epilepsy, areas of assessment should include seizure behavior, triggering stimuli, reinforcing consequences, and antiepileptic medication side effects. Assessment of these areas in this population often deviates from methods typically used with persons of normal intelligence. Specifically, direct behavioral observation and third-party report with structured interviews are the most viable and accessible means of assessment, and efforts to establish reliable and valid protocols have been successful in some areas. This article reviews this assessment methodology and discusses the extant issues in establishing and proliferating such approaches.
Erik A. Mayville, Johnny L. Matson
About one in four autistic individuals begin to have seizures during puberty. The exact reason for the onset of seizures is not known, but it is likely that the seizure activity may be due to hormonal changes in the body.
Stephen Edelson
Epilepsy or epileptiform EEGs occur in a significant minority of autistic children with a history of regression and in a smaller minority without regression.
Ronald Kallen
A critical assessment of most behaviors presented in the clinic is likely to show that they are related to the underlying disability and have, in many cases, a communicative intent.
Mike P. Kerr
Epilepsy is a well-known comorbidity of children with autism spectrum disorder (ASD), with about one third of these children developing seizures over their lifetime. Practice parameters for the diagnostic evaluation of children with ASD recommend that sleep-deprived overnight electroencephalogram studies be obtained in children with language regression or a history that suggests the possibility of seizures. This article describes the experience of a tertiary center for ASD in evaluating 316 children with overnight EEG studies who had been referred to them for language delay and possible ASD.
JA Reinhold et al
Importance of early control of active epilepsy as it relates to the physiologic and psychological sequelae of seizures; how early seizure control may affect a patient's long-term prognosis; limitations of recent clinical trials of newer AEDs; etc..
Norman Delanty, Jacqueline French
Recent data support the concept that ESES syndrome may include a large subset of developmental or acquired regressive conditions of infancy.
C.A. Tassinari, G. Rubboli, L. Volpi, S. Meletti, G. d'Orsi, M. Franca, A.R. Sabetta, P. Riguzzi, E. Gardella, A. Zaniboni, R. Michelucci
Abnormal levels of chemicals such as GABA unbalance the system and may cause a seizure. Now scientists are developing new treatments that promote harmony in the message delivery system and efficiently ward off seizures.
Leah Ariniello
We work in partnership with our clients in designing tailored epilepsy training courses that meet the development requirements of their organisation.
Sally Gomersall
Autistic disorder, epilepsy and mental retardation are probably the result of an early common dysfunction of the central nervous system.
Paola Rossia
People with mental retardation do not conform to a homogeneous group. Frequency, characteristics, and prognosis of the epileptic disorder in these individuals are strongly related to the cause of mental retardation.
Norberto Alvarez
The primary goal in evaluating a patient's first seizure is to resolve whether the seizure resulted from a treatable systemic process or intrinsic dysfunction of the central nervous system and, if the latter, the nature of the underlying brain pathology.
Steven Schachter
Negative vaccination-reactions may be occurring in some individuals. Febrile seizures induced by other physiological processes other than vaccinations may also be causally significant in some cases of autism
Teresa Binstock
The wide range of disease, epilepsy syndromes, and additional disabilities in childhood epilepsy make it essential that a scheme of categorisation of predicted outcome is used. Such an approach, proposed by Taylor et al, uses three categories: expected cure, predicted clinically significant amelioration, and procedures of less certain outcome.
B.G.R. Neville, British Medical Journal
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N. Frank Feiner
A controversial issue in the field of autism is the whole matter of EEGs, regression in autism, and treatment. Confusion arises from conflicting data, unclear definitions, and claims for treatment efficacy based on outcome measures of dubious validity.
Ronald Kallen
This study demonstrates that there is a subset of children with ASDs who demonstrate clinically relevant epileptiform activity during slow-wave sleep, and that this activity may be present even in the absence of a clinical seizure disorder.
J.D. Lewine, R. Andrews, M. Chez, A. Patil, O. Devinsky, M. Smith, A. Kanner, J.T. Davis, M. Funke, G. Jones, B. Chong, S. Provencal, M. Weisend, R.R. Lee, W.W. Orrison
Epilepsy is very common in tuberous sclerosis complex and occurs in 80 to 90% of affected individuals during their lifetime. Onset usually occurs during childhood, and up to one third of children with tuberous sclerosis complex will develop infantile spasms. Although not completely understood, the incidence of epilepsy is thought to relate to the neuropathologic features of the disorder, including cortical tubers and other dysgenetic features. Individuals with tuberous sclerosis complex frequently have epileptiform features to their electroencephalograms. Treatment of epilepsy in tuberous sclerosis complex is similar to epilepsy resulting from other causes and includes anticonvulsant medications, the vagus nerve stimulator, and the ketogenic diet. Vigabatrin has been shown to be particularly effective in treating infantile spasms in the setting of tuberous sclerosis complex. Epilepsy surgery has a very important role in the management of children and adults with pharmacoresistant epilepsy in tuberous sclerosis complex.
Elizabeth Anne Thiele
Migraine headaches in children are associated with a 3.7-fold increased risk of developing seizures. Children with migraine headaches with aura are at increased risk of developing epilepsy; children with migraine headaches without aura are not at increased risk of developing epilepsy.
David Douglas, Penny Murata
Investigators have identified a syndrome of cortical dysplasia-focal epilepsy (CDFE) that develops in Old Order Amish in early childhood, which is followed by mental retardation and aggressive behavior. The researchers linked the epilepsy to a mutation in the CNTNAP2 gene that expresses contactin-associated protein-like 2 (CASPR2). Dr. Kevin A. Strauss, at the Clinical for Special Children in Strasburg, Pennsylvania, and associates reviewed the records of nine patients with CDFE. During infancy, the children had subtle limitations in physical skills but good language comprehension, cognition, and social development. However, they also had relatively large heads and diminished or absent deep-tendon reflexes. According to their report in the March 30th issue of The New England Journal of Medicine, seizures began at ages 14 to 20 months, and tended to abate several years later. Learning ability and social behavior deteriorated after seizure onset, with patients developing hyperactivity, inattention, aggression, autism, and mental retardation.
Reuters, Medscape
The results indicated that individuals with tuberous sclerosis are at very high risk of developing an autism spectrum disorder when temporal lobe tubers are present and associated with temporal lobe epileptiform discharges and early-onset, persistent spasm-like seizures. These risk markers constitute useful clinical indicators of prognosis, but further research is required to identify the neurobiological mechanisms responsible for their association with outcome.
Patrick F. Bolton et al
In spite of the lack of comparative data, we now have new treatments, more choices and greater opportunities to help our patients achieve seizure reduction and seizure freedom than ever before, hopefully with as few side-effects as possible.
Elinor Ben-Menachem
Currently the largest epilepsy program in the Eastern United States. The Center offers testing, evaluation, screening, treatmentative therapies and surgical intervention for children, adolescents, and adults with all forms of epilepsy.
These results suggest that frontal dysfunctions are important in the mechanism of symptoms in autism.
Toshiaki Hashimotoa
Summarizes the information presented on drugs in preclinical and clinical development, including AWD 131-138, DP-valproate, harkoseride, LY300164, NPS 1776, NW 1015, pregabalin, remacemide, retigabine, rufinamide and valrocemide.
M. Bialer, S.I. Johannessen, H.J. Kupferberg, R.H. Levy, P. Loiseau, E. Perucca
The majority of autistic persons do not have seizures. However, they are at higher risk for seizures if they have certain specific neurologic conditions, such as tuberous sclerosis, neurofibromatosis, untreated phenylketonuria.
Joanna Dalldorf
There are many different types of seizures and therefore, many different types of epilepsy. It is important to distinguish amongst the different types of seizures because they require different medications, and have different causes and outcomes.
Sleep, and particularly deep non-rapid-eye-movement sleep, increase interictal epileptiform activity. Sleep increases certain seizure types and the rate of generalization of partial seizures, however rapid-eye-movement sleep seems to suppress seizures.
Carl Bazil
Epilepsy occurs in 11% of children with autism. EEG may be of prognostic value in children with autism. Regression is observed twice as often in patients with EEG abnormalities than in children without epileptiform discharges.
Xiao Yan Liu, Virginia Wong

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