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Screening electroencephalograms in autism spectrum disorders: evidence-based guideline
Tamarah Kagan-Kushnir1, S Wendy Roberts, O Carter Snead
1Bloorview MacMillian Children's Center, Toronto, ON. tkagan-kushnir@bloorviewmacmillan.on.ca
Journal of Child Neurology
|April 19, 2005
Summary
Screening electroencephalograms (EEGs) for subclinical epileptiform activity in autism spectrum disorder are not recommended due to insufficient evidence. Seizure disorders are common in autism, warranting clinical vigilance.
Area of Science:
- Neurology
- Developmental Neuroscience
- Clinical Medicine
Background:
- Autism spectrum disorder (ASD) is frequently associated with seizure disorders.
- Epileptiform abnormalities on electroencephalograms (EEGs) are common in individuals with ASD.
Purpose of the Study:
- To establish guidelines for using screening electroencephalograms (EEGs) in autism spectrum disorders.
- To identify subclinical epileptiform activity in patients with ASD.
Main Methods:
- Systematic literature search of MEDLINE and EMBASE databases.
- Evidence review using the Canadian Task Force on Preventive Health Care methodology.
- A priori criteria for article selection and evidence grading.
Main Results:
- Seizures occur in 20-30% of ASD patients; epileptiform EEG abnormalities range from 10.3% to 72.4%.
- Subclinical EEG abnormalities are found in 6.1% to 31% of patients.
- Limited evidence from case series/reports exists for anticonvulsant/corticosteroid efficacy.
Conclusions:
- Insufficient evidence currently exists to recommend for or against screening EEGs in autistic patients.
- A high index of clinical suspicion for subtle seizure symptoms is advised due to high prevalence.