Prevalence of Epilepsy in a Large Cohort of Children Diagnosed with Autistic Spectrum Disorder (ASD) in Tripoli, Libya Hospital-Based Study

Background: The knowledge about possible relationships between ASD and epilepsy is well known.There is insufficient information about the clinical characteristics of epilepsy among children diagnosed with ASD. The term 'seizure' is used to describe paroxysmal, stereotyped, relatively brief interruptions of ongoing behavior, associated with electrographic seizure patterns. 'Electrographic' means when seizures are evident on an EEG monitor.

Objectives: The aim of this study was to investigate the prevalence and characteristics of epilepsy in a large, unselected cohort of children with ASD in Tripoli, Libya.

Methods: We conducted a retrospective review of 442 children with ASD who were evaluated in our neurodevelopment clinic between the years 2012 and 2016 for epilepsy. We compared the history of epileptic activity in these children with the results of EEG. We compared our data with data from other studies in a large general pediatric population.

Results: Of children with ASD (age 4–14 years; 80% males); 10 (2.3%) had active epilepsy. This is a lower occurrence than expected in the general pediatric population. The majority of our patients had responded easily to AED’s and they were more likely to be seizure free (79%) compared to the patients with epilepsy in general pediatric population. The ASD patients with and without epilepsy did not differ regarding age, gender. The patients had been diagnosed with epilepsy on average 1.5 years before the ASD assessment. All patients with epilepsy were treated with sodium valproate (SVP) and initial response to SVP was achieved in 85%.

Conclusions: The epilepsy diagnosis preceded the ASD diagnosis, and was found in a significantly lower rate than would be expected in the general pediatric population. The majority of patients had mild epilepsy. All cases with epilepsy and ASD were treated with SVP, with initial response achieved in 86%.