New research supports evidence that people with epilepsy are at an increased risk of developing autism spectrum disorder (ASD), especially if their epilepsy begins in childhood. The study, published in the journal Neurology, also indicates that ASD is more common than usual in the siblings and offspring of people with epilepsy.
These findings suggest that it may be valuable to screen people with epilepsy and their family members for ASD, so that they can receive prompt and optimal care.
The increased risk of epilepsy in people with ASD, and especially in those with additional learning disabilities, is very well established. However, only recently have researchers begun to explore the risk of ASD in people with epilepsy.
The study
During the current study, carried out at University Hospital in Linköping, Sweden, researchers used the Swedish Patient Registry to identify more than 85,000 people with epilepsy and their siblings and children. For each of the 85,000 people with epilepsy, they selected five other people of the same age and sex, and who lived in the same county, but did not have epilepsy (controls). These were used for comparison and their siblings and children were also identified.
The scientists used the data available in the registry to find out what proportion of people in each group (people with epilepsy and controls) had been diagnosed with ASD. They then did a comparison of the ASD rates in the siblings and children of people with epilepsy, and the ASD rates in the siblings and children of controls.
The results
The findings showed that 1,381/85,000 people with epilepsy (or 1.6%) also had a diagnosis of ASD, compared to 700/425,000 (or 0.2%) of controls. This is an eight-fold increase.
The researchers conclude from this that people with epilepsy have a significantly increased risk of developing ASD. Their results also suggested that the highest risk of ASD is in people who develop epilepsy in childhood.
Focusing on the siblings and children, the team found that those of people with epilepsy also had a higher risk than normal of developing ASD than those of controls, although it was still relatively low. For the children of parents with epilepsy, the risk was shown to be higher if it was the mother who had epilepsy rather than the father, and the researchers speculate that this may be a result of exposure to antiepileptic drugs in the womb.
The exact mechanisms by which these two conditions are linked are not known. Earlier research has suggested a shared genetic basis, and the current study supports this view.
What does this mean?
A better understanding of the relationship between epilepsy and ASD could help the development of new therapies that treat them both. In the meantime, health professionals need to be made aware of these findings, so that they can manage the combined conditions more effectively.
Lead author, Dr Heléne Sundelin, comments: “The risk of autism for siblings and children to individuals with epilepsy are, despite the increase, still rather low. These results are more important for the understanding of the relationship between the disorders and should not be crucial when deciding to become a parent.”
Author: Dr Özge Özkaya
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