Epilepsy in autism: features and correlates
Open accessAbstract
Background: Epilepsy occurs in a significant minority of individuals with autism, but few long-term follow-up studies have been reported, so the prevalence, features (type of seizures, age at onset and severity, etc.) and correlates (IQ history of regression, family history) have only partially been identified. Aims: To undertake a long-term follow-up study of individuals with autism in order to better characterise the features and correlates of epilepsy in individuals with autism. Method: One hundred and fifty individuals diagnosed with autism in childhood were followed up when they were 21+ years of age. All individuals were screened for a history of possible seizures by parental/informant questionnaire. An epilepsy interview was undertaken and medical notes reviewed for individuals with a history of possible seizures. The features and correlates of epilepsy were examined using survival and regression analysis. Results: Epilepsy developed in 22% of participants. In the majority, seizures began after 10 years of age. Generalised tonic–clonic seizures predominated (88%). In over a half (19/33), seizures occurred weekly or less frequently and in the majority of individuals (28/31) they were controlled with the prescription of one to two anticonvulsants. Epilepsy was associated with gender (female), intellectual disability and poorer verbal abilities. Although the presence of epilepsy in the probands was not associated with an increased risk of epilepsy in their relatives, it was associated with the presence of the broader autism phenotype in relatives. This indicates that the familial liability to autism was associated with the risk for epilepsy in the proband. Conclusions: Epilepsy is an important medical complication that develops in individuals with autism. Seizures may first begin in adolescence or adulthood. Putative risk factors for epilepsy in autism were identified and these will require further investigation in future studies.
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About 30% of patients with ASD also have epilepsy, and about 30% of patients with epilepsy have been diagnosed with ASD.
“As they argued, and as recent studies have reminded us, 30% of patients with an ASD also have epilepsy, and 30% of patients with epilepsy have been diagnosed with an ASD (Bolton et al., 2011; Brooks-Kayal, 2010; Tuchman et al., 2009).”
From Unifying Views of Autism Spectrum Disorders: A Consideration of Autoregulatory Feedback Loops (2016) · cites this paper as Bolton et al., 2011
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- Authors
- Bolton, P. F., Carcani-Rathwell, I., Hutton, J., Goode, S., Howlin, P., & Rutter, M.
- Affiliations
- King's College London (GB)
- South London and Maudsley NHS Foundation Trust (GB)
- Corresponding author
- Bolton, Patrick F.
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2011-04
- Volume
- 198
- Issue
- 4
- Pages
- 289-294
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- PMC
- PMC3065774
- OpenAlex
- W2087045369
- Cited by
- 281
- References
- 35
- Citations by year
- 2026: 12 · 2025: 6 · 2024: 14 · 2023: 14 · 2022: 21 · 2021: 21 · 2020: 21 · 2019: 26 · 2018: 18 · 2017: 18 · 2016: 27 · 2015: 24 · 2014: 13 · 2013: 25 · 2012: 20
- FWCI
- 12.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (NF-SI-0510-10268)
- Medical Research Council
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism spectrum disorder, epilepsy, seizure onset age, generalized tonic-clonic seizures, anticonvulsant therapy, intellectual disability, verbal ability, gender differences, familial risk, broader autism phenotype, long-term follow-up, risk factors
- MeSH terms
- Adolescent, Adult, Autistic Disorder, Child, Child, Preschool, Epilepsy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Phenotype, Risk Factors, Severity of Illness Index, Antipsychotic Agents, Prevalence, Survival Analysis, Age of Onset, Young Adult
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