Thursday, 18 December 2014

Autistic traits in adults with epilepsy

"Increased autistic characteristics found in adults with epilepsy without an ASD [autism spectrum disorder] diagnosis suggest that epilepsy syndromes may incorporate behavioral aspects of autism in the absence of some of its core cognitive features."
Contrariwise, if you think we're alive you ought to speak to us.

That was the intriguing finding reported by Sally Ann Wakeford and colleagues [1] who examined test performance on the Autism Spectrum Quotient (AQ) and "systemizing and empathizing abilities" in a small-ish sample of adults with epilepsy compared with those without epilepsy. They found that: "Significantly more autistic behavioral traits, as measured by the AQ, were related to having epilepsy" but those systemising (UK spelling) and empathising abilities did not differ between the groups. The AQ, as I've indicated in previous posts, is a self-report measure and not necessarily autism-specific in terms of the features being described, so one has to be slightly cautious from this angle. But please don't let that detract from the interesting suggestion being reported...

Autism and epilepsy is an association which goes back quite a few years. Not only is epilepsy one of the more frequently reported comorbidities suggested to follow at least some diagnoses of autism (see here), epilepsy and autism co-occurring in certain situations, also provides some of the strongest evidence yet that the plural autisms might be a better definition than the catch-all categorisation that we currently use (see here). Dare I even direct you also to the preliminary research talking about joint intervention for autism and epilepsy too?

Insofar as the connection between autism and epilepsy, the Wakeford results might also imply that the genetics and biology of autism (some autism) and epilepsy (some epilepsy) might also show some kind of interplay with one and another. From me, this could imply that the research by Ong and colleagues [2] talking about a heightened risk of epilepsy in those with autoimmune disorders (see here for my take), might also extend into autism as per quite the increasing body of peer-reviewed literature talking about autoimmunity and [some] autism.

I'm also minded to suggest that despite the lack of a relationship between epilepsy and the core cognitive features of autism, I wouldn't yet rule out more subtle presentation as uniting the two diagnostic concepts [3].

Music then... Pharrell Williams - Gust of Wind.


[1] Wakeford S. et al. Autistic characteristics in adults with epilepsy. Epilepsy Behav. 2014 Oct 30;41C:203-207.

[2] Ong MS. et al. Population-level evidence for an autoimmune etiology of epilepsy. JAMA Neurol. 2014 May;71(5):569-74.

[3] Kavanaugh BC. et al. Parent-rated emotional–behavioral and executive functioning in childhood epilepsy. Epilepsy & Behavior. 2015; 42: 22-28.

---------- Wakeford S, Hinvest N, Ring H, & Brosnan M (2014). Autistic characteristics in adults with epilepsy. Epilepsy & behavior : E&B, 41C, 203-207 PMID: 25461216