Autism Spectrum Disorder and Epilepsy

Autism Spectrum Disorders (ASD) refers to a group of complex neurodevelopmental disorders characterized by persistent deficits in social communication and social interaction. Restrictive repetitive and stereotyped pattern of behavior and interests. Abnormal development that is usually present before the age of 3 years, although children’s difficulties may become obvious at a later age. 

ASD was once considered an uncommon disorder, but in the last 15 years high quality studies have demonstrated an increase in the detected prevalence. 1 in 68 children are diagnosed with autism spectrum disorder. 

Epilepsy is the most common neurological condition in India. Electrical activity is happening in the brain all the time. When there is a sudden, intense burst of electrical activity, this briefly disrupts the way the brain normally works, so the brain’s messages become mixed-up, and this leads to an epileptic seizure. Epilepsy is the tendency to have recurrent epileptic seizures.  

Epilepsy and ASD frequently coexist in the same individual at a much higher rate than would be expected by chance alone. About 1 in 10 children with ASD also have epilepsy. 

There is complex relationship between ASD, epilepsy and intellectual disability.  There are many theories regarding regression of skills in ASD where more research is needed. Intellectual disability increases the risk of epilepsy within children with autism. There are many genetic and metabolic conditions associated with both ASD and epilepsy. Some evidence to say there are two peaks of epilepsy onset in infancy and adolescence. 

There are many challenges in the diagnosis of epilepsy in children with ASD. There are many non-epileptic conditions like sensory and self-stimulatory behaviours,  blank spells, stereotyped behaviours hand flapping and body rocking which may be difficult to distinguish from epileptic-seizures. 

Careful history from parents with video recording of the movements, EEG, Video EEG can all help in the diagnosis. 

The main principles of anti-seizure medication is to improve participation, improve quality of life and reduce risk of harm from seizures. Choosing the correct drug for each individual child is important considering the seizure type and any behavioural problems. Parents should be trained in first aid for seizures and use of rescue medication like midazolam nasal spray.

In conclusion every child and family with ASD and epilepsy will have their own challenges and will need individualized treatment.

Dr Rashmi Adiga, M.B.B.S, D.C.H, M.R.C.P.C.H (U.K), C.C.T(U. K), F.R.C.P.C.H
Consultant Pediatric Neurologist, Rainbow Children’s Hospital Bannerughatta Road, Bengaluru

Dr Rashmi Adiga 

M.B.B.S, D.C.H, M.R.C.P.C.H (U.K), C.C.T(U. K), F.R.C.P.C.H

Consultant Pediatric Neurologist 

Rainbow Children’s Hospital, Bannerughatta Road, Bengaluru