CHILDREN WITH AUTISM SHOULD ALSO BE SCREENED FOR EPILEPSY; MANY GO UNDIAGNOSED, SAYS PEDIATRIC NEUROLOGIST

Voorhees, NJ - Sub-clinical seizures, which cause lapses in concentration and staring spells, are so mild that they are not apparent. These seizures can often be mistaken for symptoms of autism. That is why one prominent local pediatric neurologist says that children with autism should be screened for epilepsy as well.

“Subtle seizures can be missed in the context of autistic behaviors,” says Dr. Mark Mintz, a nationally recognized pediatric neurologist and President/CEO of The Center for Neurological and Neurodevelopmental Health (CNNH) and the Clinical Research Center of New Jersey (CRCNJ). “We know that autism presents in early childhood and that individuals with autism are at a higher risk for epilepsy. Through proper screening and diagnosis, we can improve the quality of life for children who may be suffering from both conditions.”

Epilepsy is a condition in which normal brain electrical activity malfunctions and causes recurrent seizures, characterized by an array of symptoms, including sudden change in awareness, movement or sensation. In some cases, there can be abnormal electrical activity of the brain without any observable changes, but these “sub-clinical spikes” can cause impairment of memory and learning. According to the Epilepsy Foundation, epilepsy affects more than 300,000 children under the age of 14, and approximately 10 to 30 percent of children with autism have some form of epilepsy. But for various reasons, many of those children go undiagnosed, says Mintz.

“In addition to the fact that autistic behaviors can mask epileptic symptoms, children with autism can be a difficult population to perform a traditional electroencephalogram (EEG) on, which is our primary tool for recording, diagnosing and managing abnormal brain activity,” he says. “In the past, EEGs were overlooked because the experience can be traumatic to a child with autism. Oftentimes, these children have been sedated or physically restrained.”

However, CNNH offers the latest non-invasive EEG technology, which makes the test easier and more comfortable for children with autism and other neurobehavioral disorders. Called the Dense Array EEG, recording electrodes are applied with a specially designed Geodesic Sensor Net that does not involve painful abrasion of the scalp to remove the top layer of skin or messy glues, which is necessary to do for standard EEGs.

“The net, painlessly and without infection risk, applies six times the amount of electrodes commonly used in standard EEG systems, obtaining six times the amount of data,” says Mintz, “Thus, this technology can provide a high resolution electrical ‘image’ of the brain, providing superior accuracy for localizing the source of electrical abnormalities. Such accuracy helps neurologists diagnose subtle forms of epilepsy. CNNH is the first in the region to make this advanced technology available in a clinical office setting.”

“It is important for families of children with autism to understand the importance of testing for epilepsy,” says Mintz. “Advanced diagnostic testing and specific treatment could prevent some of the risks or physical harm that can be associated with inadequate medical treatment for epilepsy.”

Mintz says the risks of injury caused by seizures include:

• Loss or impairment of consciousness and/or motor control that can result in:
  • a) Trauma
  • b) Drowning
  • c) Aspiration/choking
• Mood and Behavioral Changes
• Death, while rare, from Sudden Unexpected Death in Epilepsy Patients (SUDEP) or complications of a seizure. Seizures are a direct or contributing cause of death in 20% of individuals with autism who are brain donors to the Autism Tissue Program (2007 Curing Autism Conference Summary).

“If a definitive diagnosis of epilepsy is made, families can then take precautions, such as learning epilepsy first aid, make necessary lifestyle changes and avoiding high-risk situations such as unsupervised swimming,” says Mintz. “For some patients, anti-epileptic drugs can improve an individual’s quality of life. But the first step is proper diagnosis. Concerned parents of children with autism, or of children displaying subtle symptoms of seizures, such as unexplained staring, unresponsiveness, memory difficulties, inattentiveness, recent changes in academic productivity or behavior: such families should consult with a pediatric neurologist.”

The Center for Neurological and Neurodevelopmental Health (CNNH) offers a comprehensive and multidisciplinary model of care for infants to young adults with neurological, neurobehavioral, and neurodevelopmental disorders. CNNH brings together national and local experts to provide accurate and definitive diagnosis and comprehensive treatment using the most advanced tools and technology, such as the Dense Array EEG. Mark Mintz, M.D, is board-certified in Child Neurology, Pediatrics, and Neurodevelopmental Disabilities. For more information, please call Phyllis Rothman at 856.346.0005 x121 or visit www.thecnnh.org.

Picture of the Geodesic Dense Array EEG Sensor Net
The Center for Neurological and Neurodevelopmental Health (CNNH)