Epilepsy in adolescents and young adults with autistic disorder

Since the first description by Kanner (1943) the association between autist ic disorder (AD) and epilepsy has been observed in 4-42% of patients. Some authors reported that seizures prevailed in adolescence but a systematic in vestigation has never been undertaken. We examined retrospectively 60 patie nts divided into two groups (with and without epilepsy and EEG paroxysmal a bnormalities) with AD unrelated to a congenital or acquired encephalopathy (mean age 17 years 2 months). The aim was to investigate epilepsy, EEG paro xysmal abnormalities and possible etiological factors. The prevalence of ep ilepsy was 38.3%, much higher than that in a normal population of a similar age (6.6 parts per thousand), The prevalence of EEG paroxysmal abnormaliti es without epilepsy was 6.7%, higher than that in a population of adolescen ts and adults with psychiatric pathologies (2.6%). Seizure onset was after age 12 years in 66.7% of cases. The most common type of epilepsy was partia l in 65.2% and four patients (17.4%) had a benign childhood epilepsy with c entro-temporal spikes. Al the last observation 44.4% of patients had been s eizure-free for 2 years or more. There were no organic factors influencing the development of epilepsy but familial and personal antecedents, mental r etardation and CT scan/MRI data may suggest an early brain dysfunction resp onsible for AD and epilepsy. (C) 2000 Elsevier Science B.V. All rights rese rved.