ERIC Number: EJ904420
Record Type: Journal
Publication Date: 2004-May
Abstractor: As Provided
Reference Count: 40
Epileptic Encephalopathies and Their Relationship to Developmental Disorders: Do Spikes Cause Autism?
Tharp, Barry R.
Mental Retardation and Developmental Disabilities Research Reviews, v10 n2 p132-134 May 2004
Epileptic encephalopathies are progressive clinical and electroencephalographic syndromes where deterioration is thought to be caused by frequent seizures and abundant EEG epileptiform activity. Seizures occur in approximately 10-15% of children with pervasive developmental disorders (PDD) and 8-10% have epileptiform EEG abnormalities without seizures. Thirty percent of children with PDD have regression of social behavior and language at 2-3 years of age. Some authors speculate that the regression is caused by epileptiform activity even in the absence of overt clinical seizures ("autism with epileptic regression") and suggest that elimination of the epileptiform activity, either medically or surgically, should lead to improvement in behavior. This review examines the data showing that interictal epileptiform discharges are associated with transient clinical dysfunction and discusses the implications of these observations for autistic behavioral abnormalities. The results of resective surgery, vagal nerve stimulation, and multiple subpial transaction on children with autism and epileptiform EEG abnormalities are also discussed. I conclude that there is no evidence that interictal discharges "per se" cause (or contribute to) the complex behavioral phenotype of autism. There is no justification to support the use of anticonvulsant medication or surgery in children with PDD "without seizures"; that is, "there is no evidence that treatment" to eliminate EEG spikes will have a therapeutic effect on the behavioral abnormalities of PDD and autism.
Descriptors: Social Behavior, Autism, Seizures, Surgery, Developmental Disabilities, Brain, Epilepsy, Pervasive Developmental Disorders, Symptoms (Individual Disorders), Stimulation, Children, Drug Therapy
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Publication Type: Journal Articles; Reports - Evaluative
Education Level: N/A
Authoring Institution: N/A