Authors :
Lana jeradeh boursoulian, MD – Vanderbilt Children's Hospital; vitoria adeseye, MD – Vanderbilt University Medical Center; Kevin Ess, MD – Vanderbilt University Medical Center; Beth Malow, MD – Vanderbilt University Medical Center
Rationale: Epilepsy prevalence is higher in children with autism spectrum disorder (ASD) and is a contributor to morbidity and mortality. Little is known about the recurrence rate after the first nonfebrile seizure in this population, specifically regarding seizure type and electroencephalogram (EEG) findings.
Methods: We reviewed pediatric medical records at our de-identified record system at our institution “Synthetic Derivative (SD)” between 2006 and 2016 for subjects with ASD who had a first seizure. We then looked for risk of a recurrent non-provoked seizure within the next two years. We only included records with "idiopathic autism" and excluded ones that had other confounders that may increase the risk of having epilepsy.
Results: The recurrence rate in this study was 70.9%. This is much higher than the general population. The recurrence rate was higher in patients who had a generalized convulsion compared to those who had a behavioral arrest._x000D_
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A logistic regression model adjusted for gender and EEG found that the odds of experiencing a recurrent generalized convulsion is 5.36-fold higher than in patients with a behavioral arrest seizure (95% CI, 2.14-13.42; p < 0.001)._x000D_
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An abnormal EEG was a strong predictor of seizure recurrence in both seizure types._x000D_
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The odds of experiencing recurrence in patients with an abnormal EEG is 19.23-fold higher than in patients with normal EEG (95% CI, 5.8-63.77; p < 0.001) (Figure 2). Even with a normal EEG, generalized convulsions were more likely to recur within 2 years compared to behavioral arrest (OR 6.3; 95% CI, 2.1-19)