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Autism and Epilepsy - A missed connection

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When children are diagnosed with Autism, parents quickly become aware that the identification of Sensory Processing Disorder is likely not far behind. If a diagnosis has not been made, many SPD (Sensory Processing Disorder) behaviors may still be exhibited regardless of intensive or focused therapies needed. What is not as widely known is that children on the spectrum may also have epilepsy.

In a 2005 study conducted by Lidia Gabis, John Pomeroy, and Mary R. Andriola entitled “Autism and epilepsy: Cause, consequence, comorbidity, or coincidence?”, the researchers found that children diagnosed with ASD (Autism Spectrum Disorder) who also had "significant cognitive impairment are at a higher risk to have some form of epilepsy." Forty percent of children with autism in this study were also diagnosed with epilepsy. That’s 40% of children in one study!

This would coincide with reports of many parents that regressions occur with no known reason or that therapy that once was effective is no longer beneficial for their child. Some parents even report that their child is a ‘different person than the day before’...sometimes the hour before. The thought of epilepsy as being a part of the puzzle of Autism may be furthest from consideration since most people think of epilepsy as an obvious manifestation, as in a grand mal seizure. However, epilepsy comes in many forms.

Apart form the movements a grand mal seizure produces, seizures can be subtle as sudden behavioral changes, a sudden ‘rage’ or even sudden crying or laughing with no trigger. Blank stares, being “lost” for a moment, subtle or large jerks of the limbs, dropping of the head (as if nodding off and suddenly awakening) and sometimes with no outward manifestations during sleep, are all forms of epilepsy that can be missed.

Many parents witness these movement or “absence” occurrences without realizing that what their child is experiencing is a seizure. Mistakenly, with no one pointing out this relationship, parents can be left feeling that this is all part of an Autism Spectrum Disorder. When revealing this information to their child’s doctors, physicians can either be reluctant or unaware that a need for further investigation is warranted. This leaves parents with no answers and little direction, and a child with ASD experiencing uncontrolled, damaging seizures.

This single study however, suggests “the use of neurological investigative techniques such as electroencephalography (EEG) should be a consequence of careful clinical evaluation and should be considered routinely during evaluation of more impaired individuals.”

If you feel your child may have an epileptic disorder, have noticed unexplainable regressions, or has erratic behaviors not otherwise defined by an Autism Spectrum Disorder, it may be prudent to discuss the possibility of a seizure disorder and the investigation of such with your child’s doctor. Many times, you can begin with a pediatric neurologist, though an epileptologist (a neurologist who specialized in epilepsy) will likely be needed on your team.

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