Autism and Epilepsy: Are Autistic Children at Higher Risk of Seizures?
The subject of autism and seizures is being asked about more and more by parents of children on the spectrum.
Exact figures vary from study to study, however, it is clear that the potential for epilepsy in people with autism spectrum disorder (ASD) is high.
According to UK medical researcher Frank MC Besag, around 20% of people with ASD are at risk of epilepsy (based on previous criteria of autism), and the risk of ASD in epilepsy is also high at around 20% (based on recent epidemiologic studies).
Meanwhile, in the United States, data suggests around one third of children on the autism spectrum will also have epilepsy but only 4-5% of children with epilepsy will have ASD.
Does autism cause epilepsy or can epilepsy cause autism?
Seizures are the most common neurological complication in ASD and studies clearly show children with autism are slightly more likely to also have epilepsy.
However, research suggests there is no real evidence for autism causing epilepsy and it also appears that epilepsy is rarely the reason for autistic features.
Instead, it is believed the co-occurrence of epilepsy and autism is likely to be the result of underlying factors predisposing to both conditions, including genetic and environmental factors.
Which children with autism are more prone to seizures?
In children with autism, intellectual disability appears to be a high risk factor for developing epilepsy. There is an estimated risk of 8% for those without intellectual disability and as high as 20% for those with intellectual disability.
There are also a variety of genetic disorders linked to both autism and seizures. Risk factors include having a diagnosis of Rett’s, Fragile X, Angelman, or Prader-Willi, among other conditions. Meanwhile, conditions such as Attention Deficit Hyperactivity Disorder (ADHD), anxiety and sleep disorders are common in both epilepsy and ASD.
It’s therefore important to note autistic children who have one or more of the above diagnoses could be more likely to develop seizures; and their parents should be on alert.
Studies have also shown the male:female ratio of autism in those with epilepsy is close to 2:1, compared to a ratio of 3.5:1 in those without epilepsy.
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What types of seizures do children with autism have?
There is no single type of seizure clearly associated with autism. However, among the types of seizure worth noting are focal onset impaired awareness (complex partial), absence, tonic-clonic, and atonic, among others.
Some seizures can be easily controlled but others are more severe. There is thought to be a higher mortality rate and rate of disease associated with seizures in ASD.
What signs of seizures should autism parents look for?
According to Tasleema Khan MD, parents who are concerned their child with autism might develop seizures should pay attention to the following warning signs:
- Staring episodes (which could be signs of absence or atypical absence seizures)
- Stiffening (which could be a sign of tonic seizures)
- Rhythmic shaking or twitching (which could be a sign of focal aware/simple partial seizures)
- Loss of attention (which could be a sign of absence or focal impaired awareness/complex partial seizures)
However, it can be difficult to spot signs of epilepsy in children with autism as some ASD behaviors are similar. For example: repetitive purposeless behaviors, cognitive delay, impaired social interactions, aggression, and irritability.
What help is available for ASD children who have seizures?
Seeing your child with autism experience seizures can be frightening. However, it’s important to stay calm and remember there are ways you can manage symptoms.
Options include anti-epileptic drugs or alternative therapies such as a ketogenic diet and vagus nerve stimulations. A Magnetic Resonance Imaging (MRI) scan could also identify early white matter abnormalities for exploration.
Remember to consult your child’s doctor before choosing the best treatment for you and your family, and you must consider the interaction between any medication your child might already be taking.
Safety measures can also be implemented by parents, such as moving various objects from his/her bedroom or play area to avoid injury, turning the child on his/her side to prevent choking, and ensuring nothing is blocking his/her throat. Try to avoid restraining the child for his/her own safety as well as your own.
Not all children with autism will develop epilepsy. However, the danger of developing epilepsy in people with autism appears to be higher than for the general population. It is clear more research is needed in order to better understand the correlation between the two conditions.
By seeking medical advice and developing a strong understanding of their child’s autism (and any additional diagnoses), parents can select appropriate treatment or medication. The main take-away from current information is that help is at hand for anyone who is concerned about epilepsy and autism.