Autism Spectrum Disorder in Children with Epilepsy: A Case-Control Study in a Tertiary Care Hospital in Bangladesh

Abstract

Background: Autism spectrum disorders (ASD), a neurodevelopmental deficit, is often associated with epilepsy. Previous literature suggested that ASD and epilepsy share a common pathophysiological basis. Considering the scarcity of studies regarding ASD in children with epilepsy, this study was conducted with an aim to evaluate the association of ASD with epilepsy. Materials and Methods: This case-control study was conducted in the Department of Pediatric Neurology, Institute of Paediatric Neurodisorder and Autism, Bangabandhu Sheikh Mujib Medical University, Dhaka, from September’ 2018 to December 2019. In total, 68 epileptic children, age ranged from five to 16 years, were enrolled as case. Similar number of non-epileptic, age, sex and socio-demographic status matched children were enrolled as control. Parent, teacher and self version of Bangla Development and Well-Being Assessment were used to assess the psychiatric disorders particularly ASD and diagnosis was assigned as Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Results: The mean age of cases and controls were 9.66±3.13 and 9.26±3.11 years respectively with slight male predominance in both groups (64.7 and 57.35%, respectively). Focal seizure was predominant seizure type (51.5%) among cases. Higher proportion of psychiatric illness was found among the cases compared to controls (83.82 vs 20.59%; p<0.001). Neurodevdevelopmental and emotional disorders were significantly more frequent among cases than controls (29.42 vs 1.5%, and 50 vs 8.82%, respectively, p value <0.001). ASD was prevalent among 8.83% epileptic children, while none of the controls had ASD. Most common types of seizure in ASD children was focal epilepsy . Conclusions: This study observed the significant association of ASD with epilepsy in studied children. However, further larger multicenter study is recommended.