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Prevalence of Epilepsy and Inter-Ictal Epileptiform Discharges in Children with Autism and Attention-Deficit Hyperactivity Disorder

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Abstract

Objective

To study the prevalence of epilepsy and Inter-ictal epileptiform discharges (IED) in children with Autism spectrum disorder (ASD) and Attention-deficit hyperactivity disorder (ADHD), and the factors associated with occurrence of epilepsy in these children.

Methods

Children between 6 and 12 y attending the Child Development Centre of a tertiary-care institute in India were evaluated for ASD and ADHD as per Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Childhood Autism Rating Scale was used to assess ASD severity, and Conner’s Rating Scales were used to sub-classify children with ADHD. Intelligence quotient was assessed if not assessed in the previous 1 y. History of seizures was taken, and electroencephalography was done in all children. Epilepsy was diagnosed and classified according to International League Against Epilepsy.

Results

Of the 130 children enrolled (90 ASD, 40 ADHD), 56 (43%) had epilepsy and 55 (42.3%) had IED. The proportion of both epilepsy and IED was higher among ASD (both 45.5%) as compared to ADHD (37.5% and 35%), although not statistically significant. Among children with ASD, epilepsy was common in those with severe ASD (P < 0.001), and IED were more common in those with IQ <80 (P = 0.047). There were no significant differences between occurrence of epilepsy/IED and subtypes of ADHD.

Conclusions

The high prevalence of epilepsy and IED among children with ASD and ADHD emphasizes the need for guidelines for identifying and diagnosing epilepsy in this group. This will ensure appropriate management and improve patient outcomes.

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Authors and Affiliations

  1. Department of Pediatrics, Lok Nayak Hospital, Maulana Azad Medical College (University of Delhi), New Delhi, India

    B. Anukirthiga, Devendra Mishra & Monica Juneja

  2. Department of Neurology, GB Pant Hospital, Maulana Azad Medical College (University of Delhi), New Delhi, India

    Sanjay Pandey

  3. Child Development Center, Maulana Azad Medical College (University of Delhi), New Delhi, India

    Monica Juneja

  4. Department of Pediatrics, GR Medical College, Gwalior, 474001, India

    Neetu Sharma

Authors
  1. B. Anukirthiga
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  2. Devendra Mishra
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  3. Sanjay Pandey
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  4. Monica Juneja
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  5. Neetu Sharma
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Contributions

BA, SP, DM, MJ and NS: Study planning; BA, DM and SP: Subject assessment and evaluation; DM and NS: Statistical analysis; BA, NS and DM: Manuscript writing. MJ and SP made important intellectual contribution to data analysis and manuscript writing. All authors approved the final manuscript. DM would be the guarantor for this article.

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Correspondence to Neetu Sharma.

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Anukirthiga, B., Mishra, D., Pandey, S. et al. Prevalence of Epilepsy and Inter-Ictal Epileptiform Discharges in Children with Autism and Attention-Deficit Hyperactivity Disorder. Indian J Pediatr 86, 897–902 (2019). https://doi.org/10.1007/s12098-019-02977-6

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  • DOI: https://doi.org/10.1007/s12098-019-02977-6

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