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Characteristics of late-onset epilepsy and EEG findings in children with autism spectrum disorders

  • Lee, Ha-Neul (Department of Pediatrics, Pediatric Epilepsy Clinics, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Kang, Hoon-Chul (Department of Pediatrics, Pediatric Epilepsy Clinics, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Kim, Seung-Woo (Department of Rehabilitation Medicine, National Health Insurance Corporation Ilsan Hospital) ;
  • Kim, Young-Key (Department of Child Psychiatry, National Health Insurance Corporation Ilsan Hospital) ;
  • Chung, Hee-Jung (Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital)
  • Received : 2010.09.15
  • Accepted : 2010.11.16
  • Published : 2011.01.15

Abstract

Purpose: To investigate the clinical characteristics of late-onset epilepsy combined with autism spectrum disorder (ASD), and the relationship between certain types of electroencephalography (EEG) abnormalities in ASD and associated neuropsychological problems. Methods: Thirty patients diagnosed with ASD in early childhood and later developed clinical seizures were reviewed retrospectively. First, the clinical characteristics, language and behavioral regression, and EEG findings of these late-onset epilepsy patients with ASD were investigated. The patients were then classified into 2 groups according to the severity of the EEG abnormalities in the background rhythm and paroxysmal discharges. In the severe group, EEG showed persistent asymmetry, slow and disorganized background rhythms, and continuous sharp and slow waves during slow sleep (CSWS). Results: Between the two groups, there was no statistically significant difference in mean age (P=0.259), age of epilepsy diagnosis (P=0.237), associated family history (P=0.074), and positive abnormal magnetic resonance image (MRI) findings (P=0.084). The severe EEG group tended to have more neuropsychological problems (P=0.074). The severe group statistically showed more electrographic seizures in EEG (P=0.000). Rett syndrome was correlated with more severe EEG abnormalities (P=0.002). Although formal cognitive function tests were not performed, the parents reported an improvement in neuropsychological function on the follow up checkup according to a parent's questionnaire. Conclusion: Although some ASD patients with late-onset epilepsy showed severe EEG abnormalities, including CSWS, they generally showed an improvement in EEG and clinical symptoms in the longterm follow up. In addition, severe EEG abnormalities tended to be related to the neuropsychological function.

Keywords

References

  1. Spence SJ, Schneider MT. The Role of Epilepsy and Epileptiform EEGs in Autism Spectrum Disorders. Pediatr Res 2009;65:599-606. https://doi.org/10.1203/PDR.0b013e31819e7168
  2. Bryson SE, Clark BS, Smith IM. First report of a Canadian epidemiological study of autistic syndromes. J Child Psychol Psychiatry 1988; 29:433-445. https://doi.org/10.1111/j.1469-7610.1988.tb00735.x
  3. Hughes JR, Melyn M. EEG and seizures in autistic children and adolescents: further findings with therapeutic implications. Clin EEG Neurosci 2005;36:15-20. https://doi.org/10.1177/155005940503600105
  4. Kurita H, Osada H, Miyake Y. External validity of childhood disintegrative disorder in comparison with autistic disorder. J Autism Dev Disord 2004;34:355-362. https://doi.org/10.1023/B:JADD.0000029556.25869.71
  5. Canitano R, Luchetti A, Zappella M. Epilepsy, electroencephalographic abnormalities, and regression in children with autism. J Child Neurol 2005;20:27-31. https://doi.org/10.1177/08830738050200010401
  6. American Psychiatric Association. Diagnostic and statistical manual of mental disorder. 4th ed. Washington:American Psychiatric Association, 2000.
  7. Ballaban-Gil K, Tuchman R. Epilepsy and epileptiform EEG: association with autism and language disorders. Ment Retard Dev Disabil Res Rev 2000;6:300-308. https://doi.org/10.1002/1098-2779(2000)6:4<300::AID-MRDD9>3.0.CO;2-R
  8. Tuchman RF, Rapin I, Shinnar S. Autistic and dysphasic children. II: Epilepsy. Pediatrics 1991;88:1219-1225.
  9. Tuchman R, Rapin I. Epilepsy in autism. Lancet Neurol 2002;1:352-358. https://doi.org/10.1016/S1474-4422(02)00160-6
  10. Mouridsen SE, Rich B, Isager T. Epilepsy in disintegrative psychosis and infantile autism: a long-term validation study. Dev Med Child Neurol 1999;41:110-114. https://doi.org/10.1017/S0012162299000213
  11. Steffenburg U, Hargerg G, Hagberg B. Epilepsy in a representative series of Rett syndrome. Acta Paediatr 2001;90:34-39. https://doi.org/10.1111/j.1651-2227.2001.tb00252.x
  12. Tuchman RF, Rapin I. Regression in pervasive developmental disorders: seizures and epileptiform electroencephalogram correlates. Pediatrics 1997;99:560-566. https://doi.org/10.1542/peds.99.4.560
  13. Volkmar FR, Nelson DS. Seizure disorders in autism. J Am Acad Child Adolesc Psychiatry 1990;29:127-129. https://doi.org/10.1097/00004583-199001000-00020
  14. Capdevila OS, Dayyat E, Kheirandish-Gozal L, Gozal D. Prevalence of epileptiform activity in healthy children during sleep. Sleep Med 2008;9:303-309. https://doi.org/10.1016/j.sleep.2007.03.024
  15. Cavazzuti GB, Cappella L, Nalin A. Longitudinal study of epileptiform EEG patterns in normal children. Epilepsia 1980;21:43-55. https://doi.org/10.1111/j.1528-1157.1980.tb04043.x
  16. Rossi PG, Parmeggiani A, Bach V, Santucci M, Visconti P. EEG features and epilepsy in patients with autism. Brain Dev 1995;17:169-174. https://doi.org/10.1016/0387-7604(95)00019-8
  17. Kawasaki Y, Yokota K, Shinomiya M, Shimizu Y, Niwa S. Brief report: electroencephalographic paroxysmal activities in the frontal area emerged in middle childhood and during adolescence in a follow-up study in autism. J Autism Dev Disord 1997;27:605-620. https://doi.org/10.1023/A:1025886228387
  18. Hara H. Autism and epilepsy: a retrospective follow-up study. Brain Dev 2007;29:486-490. https://doi.org/10.1016/j.braindev.2006.12.012
  19. Chez MG, Chang M, Krasne V, Coughlan C, Kominsky M, Schwartz A. Frequency of epileptiform EEG abnormalities in a sequential screening of autistic patients with no known clinical epilepsy from 1996 to 2005. Epilepsy Behav 2006;8:267-271. https://doi.org/10.1016/j.yebeh.2005.11.001
  20. Giovanardi Rossi P, Posar A, Parmeggiani A. Epilepsy in adolescents and young adults with autistic disorder. Brain Dev 2000;22:102-106.
  21. Gabis L, Pomeroy J, Andriola MR. Autism and epilepsy: cause, consequence, comorbidity, or coincidence? Epilepsy Behav 2005;7:652-656. https://doi.org/10.1016/j.yebeh.2005.08.008
  22. Nickels K, Wirrell E. Electrical status epilepticus in sleep. Semin Pediatr Neurol 2008;15:50-60. https://doi.org/10.1016/j.spen.2008.03.002
  23. Tuchman R. CSWS-related autistic regression versus autistic regression without CSWS. Epilepsia 2009;50 Suppl 7:18-20. https://doi.org/10.1111/j.1528-1167.2009.02212.x
  24. Besag FM. Behavioral aspects of pediatric epilepsy syndromes. Epilepsy Behav 2004;5 Suppl 1:S3-S13.
  25. Piccinelli P, Borgatti R, Aldini A, Bindelli D, Ferri M, Perna S, et al. Academic performance in children with rolandic epilepsy. Dev Med Child Neurol 2008;50:353-356. https://doi.org/10.1111/j.1469-8749.2008.02040.x
  26. Kavros PM, Clarke T, Strug LJ, Halperin JM, Dorta NJ, Pal DK. Attention impairment in rolandic epilepsy: systematic review. Epilepsia 2008;49:1570-1580. https://doi.org/10.1111/j.1528-1167.2008.01610.x
  27. Hollander E, Dolgoff-Kaspar R, Cartwright C, Rawitt R, Novotnv S. An open trial of divalprox sodium in autism spectrum disorders. J Clin Psychiatry 2001;62:530-534. https://doi.org/10.4088/JCP.v62n07a05
  28. Nass R, Petrucha D. Acquired aphasia with convulsive disorder: a pervasive development disorder variant. J Child Neurol 1990;5:327-328. https://doi.org/10.1177/088307389000500411
  29. Plioplys AV. Autism: electroencephalogram abnormalities and clinical improvement with valproic acid. Arch Pediatr Adolesc Med 1994; 148:220-222. https://doi.org/10.1001/archpedi.1994.02170020106021

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