Autism and Epilepsy: Double trouble

Autism and epilepsy. What do these words mean?

An autistic child can be a challenge for parents while growing up. But having an autistic child is a learning experience of its own. The difficulty in making friends, the repetitive behavior and the struggles in the classroom are all part and parcel of raising an autistic child. However, despite the social and mental challenges, most parents tend to forget that autism sometimes has some associations with physical diseases as well.

The exact mechanism of autism is not well understood, but the most accepted mechanisms are that there is an abnormality in the arrangement of neurons or the connections between neurons which send signals around the brain, which are thought to result in an impairment in social communication, social cues and repetitive behavior. Because as the main cause is thought to be a defect in the brain signaling system, it should come as no surprise that autistic kids have a relatively higher prevalence of neurological conditions such as epilepsy and ADHD, compared to the population. In fact, the actual prevalence of epilepsy is 1-2% in the population, while it is a staggering 30% in autism. The more severe you are on the autism spectrum, the more likelihood you have of being diagnosed with epilepsy.

Sometimes autism can be caused by an underlying neurological disease such as tuberous sclerosis, metabolic diseases like phenylketonuria or exposure to some drugs such as sodium valproate in the mother’s womb.

Epilepsy is a state when you get recurrent seizures due to increased firing of your brain cells. You’ve probably encountered epileptics in your daily life when a friend is known to be really prone to shaking and frothing episodes of fits. It is a lifelong condition and is usually managed with medical therapy and many people have gone on to become successful personalities while being diagnosed with epilepsy.

How do I know if my child has epilepsy?

Now let’s move on to the most important fact: How can a parent detect it, in case you suspect that your child with diagnosed autism might have epilepsy? General tonic-clonic convulsions, which are the typical shaking episodes that you see, can be easily observed and detected. However not all seizures are like that. There is a type termed as ‘absence seizures’ where you don’t have any activity at all. These kids might just stare off into empty space for a minute or two with turning the head on to one side, drooling, and tiredness after the end of the event. You might simply think that your kid is day dreaming, but the distinction is that in an absence seizure you can’t wake them up and get their alert attention till the episode ends. Refer your child to a neurologist immediately.

What tests will they do?

Once they are at the neurologist, they might do two tests. The first is an EEG (electroencephalogram) where they look at the brain’s electrical patterns. We monitor them with the EEG until they get a seizure episode, where the brain electrical activity is disturbed. Other than that, they might do a MRI scan of the brain to see if there are any visible changes or scar tissue which might explain the recurrent seizures. Autistic people don’t typically have abnormal MRI scans.

What are the treatment options?

If there is a diagnosis of epilepsy, the treatment option is anti-seizure medications. These don’t cure epilepsy, but they reduce or remove the occurrence of seizures so that the patients can get on with their life as much as the next door neighbor. Repeated seizures or high intensity seizures might cause serious damage to the brain as well, causing a loss of certain abilities such as social skills or learning, which are already impaired in autism, so anti-seizure medication can stop your child from falling down this slope. In addition, if there is a primary cause such as a neurological disease like tuberous sclerosis, or a metabolic disease like phenylketonuria, they need to be treated for those primarily as well to stop further worsening of autism.

Autism comes a shock to parents. Having epilepsy on top of that adds to your stress. However, that is not a justifiable reason to give up. There are routes out of the challenge as modern neurology has come a really long way, along with professional counseling. Take a leap of faith and contact a neurologist to get a better plan for your situation, because there is always an answer.