Regression in pervasive developmental disorders: Seizures and epileptiform electroencephalogram correlates

被引:331
作者
Tuchman, RF
Rapin, I
机构
[1] ALBERT EINSTEIN COLL MED, SAUL R KOREY DEPT NEUROL, BRONX, NY 10467 USA
[2] ALBERT EINSTEIN COLL MED, DEPT PEDIAT, BRONX, NY 10467 USA
[3] ALBERT EINSTEIN COLL MED, ROSE F KENNEDY CTR RES MENTAL RETARDAT & HUMAN DE, BRONX, NY 10467 USA
关键词
pervasive developmental disorders; autism; regression; seizures; electroencephalogram;
D O I
10.1542/peds.99.4.560
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background. Approximately one third of the parents of children with pervasive developmental disorders or autistic spectrum disorders reports an early regression of unknown cause in their children's language, sociability, and play. Seizures or an epileptiform electroencephalogram (EEG) are associated with language regression in acquired epileptic aphasia (Landau-Kleffner syndrome) and some other pediatric epileptic syndromes. The importance of epilepsy or epileptic EEGs as contributors to autistic regression is not known. Method. Subjects were 482 bays and 103 girls on the autistic spectrum seen consecutively in consultation by one child neurologist. Data on autistic regression, seizures, sleep EEGs, and cognitive function were entered prospectively into a data base. Results. Of the 585 children, 176 (30%) had a history of regression, and 66 children (11%) had a history of epilepsy, defined as two or more unprovoked seizures. Among 392 children with available sleep EEGs, the EEG was epileptiform in 59% of the 66 epileptic children and 8% of the 335 nonepileptic children. Regression had occurred equally among children without seizures and in those with epilepsy, Regression was associated with an epileptiform EEG in 14% of 155 nonepileptic children who had undergone a regression, as opposed to 6% of 364 children with neither regression nor epilepsy. Mean age at regression was 21 months. There was no difference in the proportion of children with epilepsy or epileptiform EEGs who had regressed before or after 2 years of age. Approximately half of the epileptiform discharges were centrotemporal, whether or not the child was epileptic or had regressed. Children with lower cognitive function were more likely to have undergone regression than those with better cognitive skills (34% vs 20%). Conclusion. Epilepsy or epileptiform EEGs occur in a significant minority of autistic children with a history of regression and in a smaller minority without regression. Prompt recognition of regression and recording of prolonged sleep EEGs is recommended, even though information on the potential efficacy of antiepileptic treatment to improve language and behavior in autistic children with epilepsy or an epileptiform EEG is still lacking.
引用
收藏
页码:560 / 566
页数:7
相关论文
共 45 条
  • [1] AICARDI J, 1992, CURR OPIN NEUROL NEU, V5, P344
  • [2] AICARDI J, 1986, EPILEPSY CHILDREN, P176
  • [3] *AM PSYCH ASS, 1994, PERV DEV DIS DIAGN S, P65
  • [4] Bauman M.L., 1994, NEUROBIOLOGY AUTISM, P119
  • [5] Beaumanoir A., 1985, EPILEPTIC SYNDROMES, P181
  • [6] BEAUMANOIR A, 1995, MARIANI FDN PAED NEU, P260
  • [7] BISHOP DVM, 1985, DEV MED CHILD NEUROL, V27, P705
  • [8] DEVELOPMENT OF LOW-FUNCTIONING AND HIGH-FUNCTIONING AUTISTIC-CHILDREN
    BURACK, JA
    VOLKMAR, FR
    [J]. JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, 1992, 33 (03): : 607 - 616
  • [9] *COMM CLASS TERM I, 1989, EPILEPSIA, V26, P268
  • [10] ACQUIRED EPILEPTIFORM APHASIA IN CHILDREN (LANDAU-KLEFFNER SYNDROME)
    DEONNA, TW
    [J]. JOURNAL OF CLINICAL NEUROPHYSIOLOGY, 1991, 8 (03) : 288 - 298