Wednesday 21 January 2015

Features of autism in childhood epilepsy

"In conclusion, features of ASD [autism spectrum disorder] were common in children with epilepsy regardless of cognitive ability."

Whoa, whoa, whoa! Sorry, Blondie. I don't do backstory
So said Colin Reily and colleagues [1] in their paper examining facets of autism in cases of childhood epilepsy. Suggesting also that the Autism Spectrum Screening Questionnaire (ASSQ) might be "a useful screening instrument in this population, and combining parent and teacher forms was optimal in terms of screening properties", this work adds to other research voices suggesting a possible connection between autism/autistic traits and adult epilepsy too (see here).

I don't want to over-analyse the Reilly results beyond what they found and importantly, their limitations (as in the emphasis on 'features of autism' over and above an actual diagnosis of autism). One might see this research as further evidence of the intimate link between autism and epilepsy / seizure-type disorder(s) potentially intersecting with other issues such as sleep for example [2]. That also various other areas of biological functioning might also be related [3] makes for a potentially interesting future research agenda. Oh and then there is a possible connection with ADHD (attention-deficit hyperactivity disorder) to consider [4] too.

One of the other important issues potentially implied from the Reilly results is whether the possibility of an overlap between autistic traits and epilepsy might also have repercussions in relation to intervention and management. I say this on the basis for example, of the case report (stress: case report) recently described by Philip Bird [5] on the use of low-dose phenytoin - an anticonvulsant medicine - with a man diagnosed with ASD and the implications for various facets of functioning. Appreciating that certain anti-epileptic medications seem to have a rather less positive relationship with autism (see here), it strikes me that there may be more to see and do in this area for certain people...

Music then. I Am The Walrus. Not literally, but The Beatles song.


[1] Reilly C. et al. Features of autism spectrum disorder (ASD) in childhood epilepsy: A population-based study. Epilepsy Behav. 2014 Dec 16;42C:86-92.

[2] Accardo JA. & Malow BA. Sleep, epilepsy, and autism. Epilepsy Behav. 2014 Dec 9. pii: S1525-5050(14)00533-2.

[3] Frye RE. Metabolic and mitochondrial disorders associated with epilepsy in children with autism spectrum disorder. Epilepsy Behav. 2014 Nov 4. pii: S1525-5050(14)00412-0.

[4] Ettinger AB. et al. Attention-deficit/hyperactivity disorder symptoms in adults with self-reported epilepsy: Results from a national epidemiologic survey of epilepsy. Epilepsia. 2015. 15 Jan.

[5] Bird P. The treatment of autism with low-dose phenytoin: a case report. Journal of Medical Case Reports 2015, 9:8

---------- Reilly C, Atkinson P, Das KB, Chin RF, Aylett SE, Burch V, Gillberg C, Scott RC, & Neville BG (2014). Features of autism spectrum disorder (ASD) in childhood epilepsy: A population-based study. Epilepsy & behavior : E&B, 42C, 86-92 PMID: 25529303

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