Neuropediatrics 2006; 37 - THP104
DOI: 10.1055/s-2006-945927

EEG AND VIDEO-EEG IN CHILDREN WITH AUTISM AND STARING SPELLS

E Sell 1, I Mohamed 1, E Donner 1, A Ochi 1, H Otsubo 1
  • 1AES, AAN, Toronto, ON, Canada

Objectives: The prevalence of epilepsy in children with autism is approximately 30%. This increases the concerns of episodes of staring and abnormal behavior being epileptic in nature. We studied the incidence of abnormal EEG findings in children with diagnosis of autism referred to an epilepsy center for evaluation of staring spells.

Methods: EEG and Video EEG reports of studies performed from August 1996 to October 2005 were retrospectively reviewed using search words “autism” and “autism spectrum disorder”. Children referred specifically for investigation concerning staring episodes were included, even if they had a previous diagnosis of epilepsy and were receiving anticonvulsant medication.

Results: A total of 142 referrals were identified. 34 patients had prolonged Video EEG (VEEG) and 108 regular 30- minutes EEG. 58 (41%) studies were reported as abnormal; 26/34 (76%) Video EEG and 32/108 (30%) regular EEG. Definitive epileptiform abnormalities were observed in 40/142 (28%) studies; 27/108 (25%) EEG and 13/34 (38%) VEEG. The epileptiform discharges presented as bilateral focal frontal, and/or centro-temporal spike and wave discharges in 35/40 studies, right occipital in 2/40 and generalized in 3/40. No staring events were recorded during regular EEG. Events were recorded with video EEG in 5/34 studies. Only in 1 Video EEG study the staring correlated with ictal activity and was accompanied by subtle rhythmic limb clonic movements. Non epileptiform abnormal findings were seen in 18/142 (13%).

Conclusion: EEG and VEEG recordings are frequently abnormal in patients with autism. A significant number of these EEG abnormalities are not epileptiform. The staring spells, although reported as occurring frequently by family members, were recorded in the minority of patients admitted for prolonged VEEG recording. In only one case where staring spells proved to be epileptic in nature there was history of other seizure types and motor components associated with the recorded event.