European Child & Adolescent Psychiatry

, Volume 13, Issue 4, pp 209–213

Not EEG abnormalities but epilepsy is associated with autistic regression and mental functioning in childhood autism

  • Michal Hrdlicka
  • Vladimir Komarek
  • Lukas Propper
  • Robert Kulisek
  • Alena Zumrova
  • Ludvika Faladova
  • Marketa Havlovicova
  • Zdenek Sedlacek
  • Marek Blatny
  • Tomas Urbanek
ORIGINAL CONTRIBUTION

Abstract.

The aim of the study was to investigate the potential association of epilepsy and EEG abnormalities with autistic regression and mental retardation. We examined a group of 77 autistic children (61 boys, 16 girls) with an average age of 9.1 ± 5.3 years. Clinical interview, neurological examination focused on the evaluation of epilepsy, IQ testing, and 21-channel EEG (including night sleep EEG recording) were performed. Normal EEGs were observed in 44.4% of the patients, non-epileptiform abnormal EEGs in 17.5%, and abnormal EEGs with epileptiform discharges in 38.1% of the patients. Epilepsy was found in 22.1% of the subjects. A history of regression was reported in 25.8% of the patients, 54.8% of the sample had abnormal development during the first year of life, and 79.7% of the patients were mentally retarded. Autistic regression was significantly more frequent in patients with epilepsy than in non-epileptic patients (p = 0.003). Abnormal development during the first year of life was significantly associated with epileptiform EEG abnormalities (p = 0.014). Epilepsy correlated significantly with mental retardation (p = 0.001). Although the biological basis and possible causal relationships of these associations remain to be explained, they may point to different subgroups of patients with autistic spectrum disorders.

Key words

childhood autism epilepsy EEG autistic regression mental retardation 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Bailey A, LeCouteur A, Gottesman I, Bolton P, Simonoff E, Yuzda E, Rutter M (1995) Autism as a strongly genetic disorder: evidence from a British twin study. Psychol Med 25:63–78PubMedGoogle Scholar
  2. 2.
    Ballaban-Gil K, Tuchman R (2000) Epilepsy and epileptiform EEG: association with autism and language disorders. MRDD Res Rev 6:300–308Google Scholar
  3. 3.
    Cohen DJ, Volkmar FR (1997) Handbook of Autism and Pervasive Developmental Disorders. New York: John Wiley and SonsGoogle Scholar
  4. 4.
    Elia M, Musumeci SA, Ferri R, Bergonzi P (1995) Clinical and neurophysiological aspects of epilepsy in subjects with autism and mental retardation. Am J Ment Retard 100:6–16PubMedGoogle Scholar
  5. 5.
    Gillberg C, Steffenburg S (1987) Outcome and prognostic factors in infantile autism and similar conditions: a population-based study of 46 cases followed through puberty. J Autism Dev Disord 17:273–287PubMedGoogle Scholar
  6. 6.
    Goode S, Rutter M, Howlin P (1994) A twenty-year follow-up of children with autism. Paper presented at the 13th biennial meeting of ISSBD. Amsterdam, The NetherlandsGoogle Scholar
  7. 7.
    Hashimoto T, Sasaki M, Sugai K, Hanaoka S, Fukumizu M, Kato T (2001) Paroxysmal discharges on EEG in young autistic patients are frequent in frontal regions. J Med Invest 48:175–180PubMedGoogle Scholar
  8. 8.
    Havlovicova M, Hrdlicka M, Novotna D, Musova Z, Kocarek J, Propper L, Sedlacek Z (2003) A genetic study of 100 patients with autism spectrum disorders. Eur J Human Gen 11(Suppl 1):S109–S110CrossRefGoogle Scholar
  9. 9.
    Hrdlicka M, Propper L, Lisy J, Belsan T, Blatny M, Urbanek T (2001) Structural MRI findings in child autism. Eur Neuropsychopharmacol 11(Suppl 3):S348–S349CrossRefGoogle Scholar
  10. 10.
    Kawasaki Y, Yokota K, Shinomiya M, Shimizu Y, Niwa S (1997) Brief report: electroencephalographic paroxysmal activities in the frontal area emerged in middle childhood and during adolescence in a follow-up study of autism. J Autism Dev Disord 27:605–620CrossRefPubMedGoogle Scholar
  11. 11.
    Kobayashi R, Murata T (1998) Setback phenomenon in autism and long-term prognosis. Acta Psychiatr Scand 98:296–303PubMedGoogle Scholar
  12. 12.
    Koenig K, Rubin E, Klin A, Volkmar FR (2000) Autism and the pervasive developmental disorders. In: Zeanah CH (ed) Handbook of Infant Mental Health. 2nd ed. New York: Guilford Press, pp 298–310Google Scholar
  13. 13.
    Kurita H (1985) Infantile autism with speech loss before the age of thirty months. J Am Acad Child Psychiatry 24:191–196PubMedGoogle Scholar
  14. 14.
    Kurita H, Kita M, Miyake Y (1992) A comparative study of development and symptoms among disintegrative psychosis and infantile autism with and without speech loss. J Autism Dev Disord 22:175–188PubMedGoogle Scholar
  15. 15.
    Lewine JD, Andrews R, Chez M, Patil AA, Devinsky O, Smith M, Kanner A, Davis JT, Funke M, Jones G, Chong B, Provencal S, Weisend M, Lee RR, Orrison WW (1999) Magnetoencephalographic patterns of epileptiform activity in children with regressive autism spectrum disorders. Pediatrics 104:405–418CrossRefPubMedGoogle Scholar
  16. 16.
    Lockyer L, Rutter M (1970) A five to fifteen-year followup study of infantile psychosis: patterns of cognitive ability. Br J Soc Clin Psychol 9:152–163PubMedGoogle Scholar
  17. 17.
    Lord C, Rutter M, LeCouteur A (1994) Autism diagnostic interview-revised: a revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord 24:659–685PubMedGoogle Scholar
  18. 18.
    Mouridsen SE, Rich B, Isager T (1999) Epilepsy in disintegrative psychosis and infantile autism: a long-term validation study. Dev Med & Child Neurol 41:110–114Google Scholar
  19. 19.
    Nass R, Gross A, Devinsky O (1998) Autism and autistic epileptiform regression with occipital spikes. Dev Med & Child Neurol 40:453–458Google Scholar
  20. 20.
    Parmeggiani A, Posar A, Giovanardi-Rossi P, Andermann F, Zifkin B (2002) Autism,macrocrania and epilepsy: how are they linked? Brain Dev 24:296–299CrossRefPubMedGoogle Scholar
  21. 21.
    Rossi PG, Parmeggiani A, Bach V, Santucci M, Visconti P (1995) EEG features and epilepsy in patients with autism. Brain Dev 17:169–174CrossRefPubMedGoogle Scholar
  22. 22.
    Rossi PG, Posar A, Parmeggiani A (2000) Epilepsy in adolescents and young adults with autistic disorder. Brain Dev 22:102–106CrossRefPubMedGoogle Scholar
  23. 23.
    Rutter M (1970) Autistic children: infancy to adulthood. Seminars in Psychiatry 2:435–450PubMedGoogle Scholar
  24. 24.
    Rutter M (1984) Autistic children growing up. Dev Med Child Neurol 26:122–129PubMedGoogle Scholar
  25. 25.
    Schopler E, Reichler RJ, DeVellis RF, Daly K (1980) Toward objective classification of childhood autism: childhood autism rating scale (CARS). J Autism Dev Disord 10:91–103PubMedGoogle Scholar
  26. 26.
    Shinnar S, Rapin I, Arnold S, Tuchman RF, Shulman L, Ballaban-Gil K,Maw M, Deuel RK, Volkmar FR (2001) Language regression in childhood. Pediatr Neurol 24:185–191CrossRefGoogle Scholar
  27. 27.
    Small JG (1975) EEG and neurophysiological studies of early infantile autism. Biol Psychiatry 10:385–397PubMedGoogle Scholar
  28. 28.
    Tuchman R, Rapin I (1997) Regression in pervasive developmental disorders: seizures and epileptiform electroencephalogram correlates. Pediatrics 99:560–566CrossRefPubMedGoogle Scholar
  29. 29.
    Tuchman RF, Rapin I, Shinnar S (1991) Autistic and dysphasic children. I: clinical characteristics. Pediatrics 88:1211–1218PubMedGoogle Scholar
  30. 30.
    Tuchman RF, Rapin I, Shinnar S (1991) Autistic and dysphasic children. II: epilepsy. Pediatrics 88:1219–1225PubMedGoogle Scholar
  31. 31.
    Uson JRV, Villalba BA, Garcia MM, Capdevilla OS (2002) Nocturnal polysomnogram in childhood autism without epilepsy (Article in Spanish). Revista de neurologia 31:1101–1105Google Scholar
  32. 32.
    Volkmar FR (1998) Autism and pervasive developmental disorders. Cambridge: Cambridge University PressGoogle Scholar
  33. 33.
    Volkmar FR, Nelson DS (1990) Seizure disorder in autism. J Am Acad Child Adolesc Psychiatry 29:127–129PubMedGoogle Scholar

Copyright information

© Steinkopff Verlag 2004

Authors and Affiliations

  • Michal Hrdlicka
    • 1
  • Vladimir Komarek
    • 2
  • Lukas Propper
    • 1
  • Robert Kulisek
    • 1
  • Alena Zumrova
    • 2
  • Ludvika Faladova
    • 2
  • Marketa Havlovicova
    • 3
  • Zdenek Sedlacek
    • 3
  • Marek Blatny
    • 4
  • Tomas Urbanek
    • 4
  1. 1.Department of Child PsychiatryCharles University, 2nd Medical SchoolPragueCzech Republic
  2. 2.Department of Child NeurologyCharles University, 2nd Medical SchoolPragueCzech Republic
  3. 3.Institute of Biology and Medical GeneticsCharles University, 2nd Medical SchoolPragueCzech Republic
  4. 4.Institute of PsychologyAcademy of SciencesBrnoCzech Republic

Personalised recommendations