Raising a child on the autism spectrum can be challenging and it’s even more so if your child also receives a diagnosis of epilepsy. Here’s everything you need to know about the link between the two conditions, common seizure types, and available treatments.
What Is Epilepsy?
Epilepsy is among the most common neurological disorders. An estimated 3 million Americans live with epilepsy and nearly 200,000 people in the United States develop the condition every year.
Epilepsy is a result of an imbalance in brain chemistry that causes the messages traveling between neurons to become scrambled.
What is a seizure?
An epileptic seizure refers to a burst of electrical activity in the brain that temporarily affects the way the brain works and impairs everyday functioning.
Epileptic seizures can cause a wide range of symptoms. Below, we list the most common ones.
Common Symptoms of Epilepsy in Autism
Symptoms of epilepsy in children with autism may include:
- Periods of rapid eye blinking and staring
- Appearing confused or in a haze
- Not responding for brief periods
- Stiffening of the body
- Jerking movements of the arms and legs
- Breathing problems
- Loss of bowel or bladder control
- Falling suddenly for no apparent reason
- Nodding the head rhythmically, when associated with loss of awareness
- Loss of consciousness
Some of these symptoms are similar to signs of other medical conditions. They may also be caused by nonepileptic seizures, which are not a result of abnormal electrical activity in the brain but due to stress and other psychological causes.
The nature of your child’s symptoms will depend on the type of epileptic seizure. In the following section, we explain seizure types in children with autism.
Types of Epileptic Seizures
Epileptic seizures can be categorized into two broad types: focal and generalized. Children on the autism spectrum can experience most forms of epileptic seizures.
Focal seizures
Focal seizures are localized in one area on one side of the brain, but they can become generalized and spread to other areas.
This type of seizure causes the following symptoms:
- Involuntary jerking of a body part
- Tingling
- Dizziness
- Flashing lights
- Staring into space
- Repetitive movements (hand rubbing, swallowing)
- Loss of awareness
- Loss of consciousness
Generalized seizures
Generalized seizures affect both sides of the brain. They can take different forms, each characterized by its own set of symptoms:
- Absence seizures
- Loss of awareness
- Staring
- Subtle body movements
- Tonic seizures
- Stiffening of muscles
- Falling
- Atonic seizures
- Sudden collapse
- Clonic seizures
- Rhythmic muscle movements in the neck, face, and arms
- Myoclonic seizures
- Sudden twitches in the arms and legs
- Tonic-clonic seizures
- Body stiffening and shaking
- Loss of bladder control
- Tongue biting
- Abrupt loss of consciousness
Is There a Link between Autism and Epilepsy?
Multiple studies suggest that autism and epilepsy have a common genetic origin, although the exact reason for this comorbidity is not known. Because there is a significant overlap between genes linked to the two conditions, children with autism are much more likely to have epilepsy than their neurotypical peers.
Around 26% of children with autism are diagnosed with epilepsy, whereas fewer than 1% of children who are not on the spectrum develop seizures. What’s more, many children with autism show abnormalities on EEGs that suggest epilepsy, even if they have never experienced seizures. Similarly, children with epilepsy are more likely to have autism than their neurotypical peers.
Epilepsy in children on the autism spectrum often starts in the teenage years, which is much later than in the general population. In children without autism, the risk of epilepsy is greatest in the first year of their life.
How to Diagnose Epilepsy
Epilepsy is diagnosed by a pediatrician or neurologist. The diagnosis process is the same whether the child is on the autism spectrum or not. Typically, the doctor will try to find out the cause of the seizures by performing a variety of tests, such as:
- EEG (electroencephalogram) records the electrical activity in the brain
- CT scan or MRI can show structural abnormalities in the brain
- A blood test may identify whether there are conditions such as infections, iron deficiency, or diabetes that may be triggering the seizures
- Lumbar puncture or spinal tap determines whether an electrolyte abnormality or infection is the reason for seizures
- Genetic testing may help find a gene mutation that explains the presence of both autism and epilepsy.
Continue reading to find out how you can best support your child after receiving an epilepsy diagnosis.
Supporting Children with Autism and Epilepsy with Seizures
There are many aspects of supporting your child with autism and epilepsy that you should take into account, for example, overcoming communication issues, correctly interpreting seizure signs, and informing others about your child’s condition.
Teach your child to communicate symptoms
If your child has communication issues or is non-verbal, it will be difficult to explain sensations related to seizures, such as a strange taste in the mouth or blurred vision. These signs may not be obvious to others, making it harder to get the right help on time.
If your child uses alternative communication methods, you can show them how to explain their feelings using visual aids like social stories, symbols, or pictograms of the body.
Know the triggers
It is important that teachers, caretakers, and other individuals involved in your child’s life are aware of the triggers that may provoke seizures. Knowing what the triggers are may in some cases help prevent epileptic seizures.
Some common triggers include:
- Flashing lights
- Fever
- Sudden onset of illness
- Lack of sleep
- Stress
- Missing a dose of anti-epileptic medication
Correctly interpret the signs of an epileptic seizure
In children on the autism spectrum, there’s a risk that the signs of a seizure are misinterpreted as sensory issues related to autism rather than epilepsy. That’s why it is important to be aware of any small changes in your child’s behavior that might indicate that something is not quite right, such as staring, repetitive movements, fidgeting, slapping lips, or becoming unusually clingy.
Use prescribed medications
If your child has been prescribed anti-epileptic drugs to control seizures, it is essential to use them regularly and exactly as instructed. Finding the best medication and dose can take time, and it is crucial to follow the doctor’s advice.
Keep everyone informed
Be sure to share the information about your child’s epilepsy with other family members, teachers, therapists, and caretakers. Inform them about seizure triggers, the typical duration of seizures and recovery, and the ways to best communicate with your child when they’re experiencing signs of a seizure. They should also know when it is necessary to call the emergency services, for example, if your child:
- Stops breathing
- Gets injured during the seizure
- The seizure lasts for more than five minutes
- Another seizure occurs before regaining consciousness
In the section below, we take a look at the available treatments for children diagnosed with epilepsy.
Treatment Options for Seizures
If your child is suspected to have epilepsy, your pediatrician will refer you to a neurologist (a doctor specializing in brain function) or an epileptologist (a neurologist sub-specializing in epilepsy) for further treatment.
The treatments for epilepsy in children with autism are the same as those for children who have only epilepsy but not autism. The most commonly used treatment for epileptic seizures consists of taking anti-epileptic drugs.
Anti-epileptic drugs (AEDs)
Anti-epileptic drugs work by controlling the electrical activity in the brain that causes seizures and are effective in around 70% of patients.
Types of AEDs
There are many types of anti-epileptic drugs that your doctor may prescribe, depending on the type of seizures your child is experiencing.
The most common ones include:
- Sodium valproate (prescribed for all seizure types)
- Carbamazepine (partial seizures and tonic-clonic seizures)
- Lamotrigine (partial seizures and primary generalized tonic-clonic seizures)
- Levetiracetam (partial-onset seizures)
- Topiramate (primary generalized tonic-clonic seizures)
Most children will have to take anti-epileptic drugs their entire lives, but sometimes it may be possible to stop taking the medications, for example, if seizures disappear. This may be the case if you know your child’s seizure triggers and are able to avoid them.
Side effects of AEDs
As with most medications, anti-epileptic drugs may cause a wide range of side effects, including:
- Neurological side effects
- Involuntary muscle movements (ataraxia)
- Uncontrollable shaking (tremors)
- Rapid and repetitive eye movements (nystagmus)
- Behavioral side effects
- Hyperactivity
- Agitation
- Aggressiveness
- Gastrointestinal side effects
- Abdominal pain
- Nausea
- Allergic reactions such as rashes, which may in some cases become severe
Other treatment options
In addition to anti-epileptic drugs, there are several other effective treatment options for epilepsy:
- A high-fat, low-carbohydrate ketogenic diet that may help control seizures
- Vagus nerve stimulation (VNS), where a small device implanted under the skin sends regular, mild pulses of electrical energy to the brain via the vagus nerve
- Deep brain stimulation (DBS), where electrical stimulation is provided to brain areas involved in seizures through electrodes implemented in certain areas of the brain
- Brain surgery that removes a small part of the brain that is causing the seizures.
If you are ready to work with the best ABA therapy provider in New York, New Jersey or Indiana, give us a call at (732) 402-0297. Our dedicated team is ready to help and we will treat you like family.
