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Seizures and epilepsy among children with language regression and autistic spectrum disorders

Edwin Trevathan1

  • 1Pediatric Epilepsy Center, Departments of Neurology and Pediatrics, Washington University School of Medicine, Campus Box 8111, 660 South Euclid Avenue, St. Louis, MO 63110-1093, USA. trevathan@wustl.edu

Journal of Child Neurology
|November 6, 2004
PubMed

Insights

Children with autistic spectrum disorder (ASD) frequently experience seizures, particularly those with language regression. Effective epilepsy treatments for ASD are needed, alongside research into the link between sleep seizures and language loss.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Epileptology

Background:

  • Autistic spectrum disorder (ASD) is frequently associated with clinical and subclinical seizures.
  • Continuous spike-wave in slow-wave sleep (CSWS) is characteristic of acquired epileptic aphasia and Landau-Kleffner syndrome (LKS).
  • Seizures and epilepsy are more prevalent in children with ASD who exhibit language regression, especially after age two.

Purpose of the Study:

  • To review the relationship between epilepsy, language regression, and specific EEG patterns in children with ASD.
  • To discuss current treatment approaches and identify gaps in evidence-based interventions for epilepsy in ASD.
  • To highlight the need for further research into the etiology and treatment of LKS and acquired epileptic aphasia in the context of ASD.

Main Methods:

  • Literature review of studies on epilepsy and language regression in ASD.
  • Analysis of the characteristics of electrographic status epilepticus in sleep (ESES) and its association with LKS and acquired epileptic aphasia.
  • Discussion of antiepileptic drug (AED) efficacy and safety profiles in pediatric populations with ASD.

Main Results:

  • Children with ASD and language regression, particularly after age two, have a higher incidence of seizures and epilepsy.
  • While seizures in LKS and acquired epileptic aphasia can be managed, language function improvement is not guaranteed post-treatment.
  • No randomized clinical trials currently exist for treating LKS or autistic language regression.

Conclusions:

  • Broad-spectrum antiepileptic drugs that do not cause cognitive slowing are recommended for epilepsy management in children with ASD.
  • Large-scale, multisite trials are essential to evaluate treatment efficacy for LKS and acquired epileptic aphasia.
  • Further research is required to ascertain a causal link between ESES and autistic language regression.

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