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Autistic and dysphasic children. II: Epilepsy
R F Tuchman1, I Rapin, S Shinnar
1Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, New York.
Insights
Epilepsy risk is higher in autistic children, particularly those with severe cognitive or motor deficits. However, once these factors are accounted for, the epilepsy risk is similar between autistic and dysphasic children.
Area of Science:
- Neurodevelopmental disorders
- Pediatric neurology
- Epileptology
Background:
- Autism Spectrum Disorder (ASD) and developmental expressive language disorder (dysphasia) are neurodevelopmental conditions often co-occurring with other medical issues.
- Epilepsy is a known comorbidity in children with neurodevelopmental disorders, but the specific risk factors and comparative prevalence require further investigation.
Purpose of the Study:
- To investigate the prevalence and risk factors for epilepsy in a cohort of autistic and dysphasic children.
- To compare the risk of epilepsy between autistic and nonautistic dysphasic children, considering various clinical and demographic factors.
Main Methods:
- Retrospective analysis of a cohort including 302 autistic and 237 dysphasic children (excluding 12 autistic girls with Rett syndrome).
- Statistical comparison of epilepsy prevalence between groups and identification of associated risk factors such as severe mental deficiency, motor deficits, and family history.
- Subgroup analysis based on language subtype (verbal auditory agnosia) and sex.
Main Results:
- Overall epilepsy prevalence was 14% in autistic children and 8% in dysphasic children (P = .03).
- Severe mental deficiency and combined severe mental and motor deficits were major risk factors for epilepsy.
- The language subtype verbal auditory agnosia showed the highest epilepsy risk (41% in autistic, 58% in dysphasic children).
- Autistic girls had a higher epilepsy rate (24%) than boys (11%), linked to increased cognitive/motor deficits.
- After adjusting for cognitive and motor deficits, epilepsy risk was comparable between autistic and dysphasic children.
Conclusions:
- While autistic children exhibit a higher epilepsy prevalence, this is largely explained by associated severe cognitive and motor deficits.
- Specific subgroups, like those with verbal auditory agnosia, face a significantly elevated epilepsy risk.
- The findings underscore the importance of comprehensive assessment for comorbidities in neurodevelopmental disorders.
Abstract:
In a previously described population of 314 autistic and 237 dysphasic nonautistic children, after exclusion of 12 autistic girls with Rett syndrome, 14% (42 of 302) of autistic children and 8% (19 of 237) of dysphasic children had epilepsy (P = .03). The major risk factors for epilepsy were severe mental deficiency and the combination of severe mental deficiency with a motor deficit. In autistic children without severe mental deficiency, motor deficit, associated perinatal or medical disorder, or a positive family history of epilepsy, epilepsy occurred in 6% (10 of 160) which was analogous to the 8% (14 of 168) found in similar dysphasic nonautistic children. The language subtype of verbal auditory agnosia is associated with the highest risk of epilepsy in autistic (41%, 7 of 17) and dysphasic (58%, 7 of 12) children. The higher percentage of epilepsy in autistic girls, 24% (18 of 74) compared with boys 11% (25 of 228) (P = .003), is attributed to the increased prevalence of cognitive and motor deficit in girls. Once the risk attributable to associated cognitive and motor disabilities is taken into account, there is no difference in the risk of epilepsy between autistic and nonautistic dysphasic children.