Valproic acid treatment of epilepsy in autistic twins

Case histories of autistic twins with absence seizures are presented. The boys had autistic features prior to the onset of seizures during their second year of life. By age 3 years, the twins were significantly delayed in the areas of socialization, communications and impulse control. Typical autistic features were pronounced, including perseverative, nonpurposeful and self-stimulatory behaviors; lack of symbolic play; poor eye contact; echolalic and noncommunicative speech; and unresponsiveness to disciplinary efforts. The absence seizures, although first observed by the parents early in the twins' second year, were not diagnosed until age 3 years 1 month. The seizures consisted of 50-60 staring spells per day. Both boys responded to valproic acid treatment with control of their seizures and with a dramatically accelerated rate of acquisition of both language and social skills. A possible causal relationship between autism and absence seizures in these children is explored.