EEG Changes May Signal Seizure Risk In Autism

What was studied

This study looked at whether epilepsy in children with autism spectrum disorder (ASD) was associated with results from neurologic evaluations, including EEG, brain imaging, genetic testing, and developmental assessments.

Researchers retrospectively reviewed records from 99 children with ASD seen at one tertiary center from 2012 to 2021. The average age was about 10 years, and about 77% were boys. Not every child had every test: 51 had an EEG, and 42 had chromosomal microarray genetic testing.

What they found

Epilepsy was diagnosed in 22.2% of the children (22 out of 99). Among the 51 children who had an EEG, 43.1% had abnormal EEG results. EEG abnormalities were more common in children with seizures than in those without seizures: 77.3% versus 6.4%.

The study found significant associations between epilepsy and abnormal EEG findings and between epilepsy and pathogenic genetic variants on chromosomal microarray testing. In this cohort, abnormal EEG findings were the strongest independent predictor of epilepsy, followed by pathogenic genetic variants. The study did not find a significant association between epilepsy and gender or intellectual disability.

Limits of the evidence

This was a retrospective study, which means the researchers looked back at existing records rather than following children forward in time. Because of that, the study can show associations but cannot establish that abnormal EEG findings or genetic variants cause epilepsy.

It was done at a single tertiary center, so the results may not apply to all children with ASD. Also, not all children had EEG or genetic testing, which can affect how the findings are interpreted. The abstract does not give details about the types of seizures, the exact EEG abnormalities, or the developmental assessment findings.

For families and caregivers

For families, this study suggests that epilepsy and EEG abnormalities may be common in children with ASD in this specialty clinic cohort. It also suggests that children with abnormal EEGs or pathogenic genetic findings may be more likely to have epilepsy.

This does not mean every child with ASD needs an EEG right away, and the study itself says more research is needed before broader or routine EEG at diagnosis can be recommended. Still, the findings support strongly considering EEG in children with ASD who have seizures, developmental regression, unexplained paroxysmal events, or pathogenic genetic variants.

What to watch next

The abstract calls for prospective studies to determine whether broader, potentially routine EEG at diagnosis is warranted, including its diagnostic yield, cost-effectiveness, and long-term outcomes.

Terms in this summary

EEG

A test that records the brain's electrical activity using sensors placed on the scalp.

epilepsy

A condition in which a person has repeated seizures.

pathogenic variant

A genetic change classified as disease-causing.

chromosomal microarray

A genetic test that looks for missing or extra pieces of DNA across the chromosomes.

retrospective study

A study that looks back at information already recorded in medical charts or databases.

tertiary center

A specialized hospital or clinic that often sees more complex cases.

independent predictor

A factor that remains associated with an outcome after other factors are considered in a statistical model.

developmental regression

Loss of skills a child had already learned, such as language or social skills.