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Journal of Pediatric Epilepsy 2022; 11(02): 039-044
DOI: 10.1055/s-0041-1736557
Original Article

Electroencephalogram Abnormalities and Epilepsy in Autism Spectrum Disorders: Clinical and Electroencephalogram Findings

Fatma Hanci 
1   Division of Child Neurology, Department of Pediatrics, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
,
Sevim Türay 
2   Division of Child Neurology, Department of Pediatrics, Faculty of Medicine, Düzce University, Düzce, Turkey
,
Yusuf Öztürk 
3   Department of Child and Adolescent Psychiatry, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
,
Nimet Kabakus 
1   Division of Child Neurology, Department of Pediatrics, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
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Abstract

It has been known for several decades that epilepsy and autism spectrum disorders (ASD) are related to each other. Epilepsy frequently accompanies ASD. The purpose of this study was to investigate relationship between clinical and electroencephalogram (EEG) findings in ASD patients and to identify EEG characteristics that may create a disposition to epilepsy in ASD by examining differences in clinical and EEG findings between patients diagnosed with ASD without epilepsy and ASD with epilepsy. A total of 102 patients aged 2 to 18 years and diagnosed with ASD based on Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic criteria between January 2017 and June 2019 were included in the study. Patients were assigned into two groups: (1) ASD with epilepsy and (2) ASD without epilepsy. Clinical findings were retrieved from patients' files, and EEG findings from first EEG records in the EEG laboratory at the time of diagnosis. EEG findings were defined as central, parietal, frontal, temporal, or generalized, depending on the location of rhythmic discharges. The incidence of epilepsy in our ASD patients was 33.7% and that of febrile convulsion was 4%. Generalized motor seizures were the most common seizure type. Epileptic discharges most commonly derived from the central and frontal regions. These abnormalities, especially frontal and central rhythmic discharges, may represent a precursor for the development of epilepsy in ASD patients.

Keywords

autism spectrum disorders - electroencephalography - epilepsy


Publication History

Received: 30 June 2021

Accepted: 04 September 2021

Article published online:
29 October 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders. 5th ed.. Washington, DC: American Psychiatric Publishing; 2013
    CrossrefGoogle Scholar
  • 2 Kanner L. Autistic disturbances of affective contact. Acta Paedopsychiatr 1968; 35 (04) 100-136
    Google Scholar
  • 3 Zafeiriou DI, Ververi A, Vargiami E. Childhood autism and associated comorbidities. Brain Dev 2007; 29 (05) 257-272
    CrossrefPubMedGoogle Scholar
  • 4 Amiet C, Gourfinkel-An I, Bouzamondo A. et al. Epilepsy in autism is associated with intellectual disability and gender: evidence from a meta-analysis. Biol Psychiatry 2008; 64 (07) 577-582
    CrossrefPubMedGoogle Scholar
  • 5 Canitano R. Epilepsy in autism spectrum disorders. Eur Child Adolesc Psychiatry 2007; 16 (01) 61-66
    CrossrefPubMedGoogle Scholar
  • 6 Spence SJ, Schneider MT. The role of epilepsy and epileptiform EEGs in autism spectrum disorders. Pediatr Res 2009; 65 (06) 599-606
    CrossrefPubMedGoogle Scholar
  • 7 Swatzyna RJ, Boutros NN, Genovese AC, MacInerney EK, Roark AJ, Kozlowski GP. Electroencephalogram (EEG) for children with autism spectrum disorder: evidential considerations for routine screening. Eur Child Adolesc Psychiatry 2019; 28 (05) 615-624
    CrossrefPubMedGoogle Scholar
  • 8 Tuchman R, Rapin I. Epilepsy in autism. Lancet Neurol 2002; 1 (06) 352-358
    CrossrefPubMedGoogle Scholar
  • 9 Kanemura H, Sano F, Tando T, Sugita K, Aihara M. Can EEG characteristics predict development of epilepsy in autistic children?. Eur J Paediatr Neurol 2013; 17 (03) 232-237
    CrossrefPubMedGoogle Scholar
  • 10 Yasuhara A. Correlation between EEG abnormalities and symptoms of autism spectrum disorder (ASD). Brain Dev 2010; 32 (10) 791-798
    CrossrefPubMedGoogle Scholar
  • 11 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 (01) 267-271
    CrossrefPubMedGoogle Scholar
  • 12 Hara H. Autism and epilepsy: a retrospective follow-up study. Brain Dev 2007; 29 (08) 486-490
    CrossrefPubMedGoogle Scholar
  • 13 Doernberg E, Hollander E. Neurodevelopmental Disorders (ASD and ADHD): DSM-5, ICD-10, and ICD-11. CNS Spectr 2016; 21 (04) 295-299
    CrossrefPubMedGoogle Scholar
  • 14 Anlar B, Yalaz K. Denver II gelişimsel tarama testi Türk çocuklarına uyarlanması ve standardizasyonu el kitabı. Ankara Meteksan Matbası; 1996
    Google Scholar
  • 15 Savaşır I, Şahin N. Wechsler çocuklar için zeka ölçeği (WISC-R) el kitabı. Ankara Türk Psikologlar Derneği Yayınları; 1995: 13-52
    Google Scholar
  • 16 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed.. Text Revision [DSM–IV-TR]. Washington, DC: American Psychiatric Publishing; 2000
    Google Scholar
  • 17 Fisher RS, Cross JH, D'Souza C. et al. Instruction manual for the ILAE 2017 operational classification of seizure types. Epilepsia 2017; 58 (04) 531-542
    CrossrefPubMedGoogle Scholar
  • 18 Tuchman RF, Rapin I, Shinnar S. Autistic and dysphasic children. II: Epilepsy. Pediatrics 1991; 88 (06) 1219-1225
    CrossrefPubMedGoogle Scholar
  • 19 Danielsson S, Gillberg IC, Billstedt E, Gillberg C, Olsson I. Epilepsy in young adults with autism: a prospective population-based follow-up study of 120 individuals diagnosed in childhood. Epilepsia 2005; 46 (06) 918-923
    CrossrefPubMedGoogle Scholar
  • 20 Couter AL, Szatmari P. Autism spectrum disorder. In: Thapar A, Pine DS, Leckman JF, Scott S, Snowling MJ, Taylor E. eds. Rutter's Child And Adolescent Psychiatry. 6th ed.. Ames, IA: Wiley, Blackwell; 2015: 665-683
    Google Scholar
  • 21 Beggiato A, Peyre H, Maruani A. et al. Gender differences in autism spectrum disorders: divergence among specific core symptoms. Autism Res 2017; 10 (04) 680-689
    CrossrefPubMedGoogle Scholar
  • 22 Lai MC, Lerch JP, Floris DL. et al. Imaging sex/gender and autism in the brain: etiological implications. J Neurosci Res 2017; 95 (1-2): 380-397
    CrossrefPubMedGoogle Scholar
  • 23 Ekinci O, Arman AR, Işik U, Bez Y, Berkem M. EEG abnormalities and epilepsy in autistic spectrum disorders: clinical and familial correlates. Epilepsy Behav 2010; 17 (02) 178-182
    CrossrefPubMedGoogle Scholar
  • 24 Posar A, Visconti P. Some considerations about the association between autism spectrum disorder and epilepsy. Turk Pediatri Ars 2020; 55 (03) 331-332
    PubMedGoogle Scholar
  • 25 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 of autism. J Autism Dev Disord 1997; 27 (05) 605-620
    CrossrefPubMedGoogle Scholar
  • 26 Hashimoto T, Sasaki M, Sugai K, Hanaoka S, Fukumizu M, Kato T. Paroxysmal discharges on EEG in young autistic patients are frequent in frontal regions. J Med Invest 2001; 48 (3,4): 175-180
    PubMedGoogle Scholar
  • 27 Alaimo H, Geller E, Mahalingam R. et al. Ictal EEG in patients with autistic spectrum disorder and epilepsy. Epilepsy Res 2020; 168: 106482
    CrossrefPubMedGoogle Scholar
  • 28 Rossi PG, Parmeggiani A, Bach V, Santucci M, Visconti P. EEG features and epilepsy in patients with autism. Brain Dev 1995; 17 (03) 169-174
    CrossrefPubMedGoogle Scholar
  • 29 Gillberg C, Steffenburg S. Outcome and prognostic factors in infantile autism and similar conditions: a population-based study of 46 cases followed through puberty. J Autism Dev Disord 1987; 17 (02) 273-287
    CrossrefPubMedGoogle Scholar
  • 30 Volkmar FR, Nelson DS. Seizure disorders in autism. J Am Acad Child Adolesc Psychiatry 1990; 29 (01) 127-129
    CrossrefPubMedGoogle Scholar
  • 31 Goulden KJ, Shinnar S, Koller H, Katz M, Richardson S. Incidence of seizures in the mentally retarded: the Aberdeen cohort data. Epilepsia 1987; 28 (05) 623
    PubMedGoogle Scholar