Epilepsy And Autism: Is There A Connection?

If your child has been diagnosed with epilepsy, you might be wondering what this means for them. Are they more likely to have other neurological conditions? Will it affect their development? Does having epilepsy mean that they will develop autistic traits too? What, if anything, is the connection between epilepsy and autism? We cover all of this in our article. 

What is epilepsy?

Epilepsy is a term used to describe a group of neurological conditions characterized by seizures. A seizure is a burst of uncontrolled electrical activity in the brain. Seizures can have different effects, depending on where in the brain they are located and how much of the brain is impacted by the seizure. 

In the United States, approximately three million adults and 470,000 children live with active epilepsy.  

What is autism?

Autism spectrum disorder (ASD) is a developmental condition that arises during brain development. Individuals with ASD have neurodivergent brains, meaning they have features that differ from those of a typical brain. 

ASD is known as a “spectrum” because there is a wide range of ways this condition can look. Some people with autism are highly capable and can live independent lives, while others need help with basic daily tasks. 

In general, autism is characterized by social communication difficulties and sensory processing differences. In affected people, the characteristics of ASD are usually visible before the age of three. The condition is currently estimated to affect 1 in every 44 children in the US,¹ and it has been growing more frequent.

Is there a connection between autism and epilepsy?

There seems to be a connection between autism and epilepsy. Compared to the general population, children with ASD are more likely to have epilepsy, and children with epilepsy are more likely to have ASD. However, the reasons for this connection are not yet clearly understood.

Children with ASD

Research² suggests that children with ASD are seven times more likely to develop epilepsy than children without ASD. 

The link between ASD and epilepsy seems stronger in children with intellectual disabilities. In a study³ of 286 children with autism, the prevalence of epilepsy was 7% among those with no motor deficits or severe intellectual disabilities. However, it shot up to 42% in those with motor deficits and severe intellectual disabilities. 

Other factors that appear to increase the risk of ASD in children with epilepsy include being female, being of older age, and having lower socio-economic status. Epilepsy in children with ASD also tends to be more severe than epilepsy in typically developing children. It’s harder to treat and is more likely to cause death.

Children with epilepsy

A review of existing research in 2017 found that 6.3% of people with epilepsy also have autism. This is considerably higher than in the general population, where approximately 1% of people have autism. Certain specific types of epilepsy, such as complex partial seizures and Dravet syndrome, appear to be associated with a higher prevalence of ASD than others.

Theories about the link between epilepsy and autism

While it’s clear that there’s a relationship between autism and epilepsy, the exact nature of this relationship is still under investigation. The following are some possibilities:

• Seizures in very young children may cause nervous system changes, making it more likely for the child to develop ASD.

• Certain genetic factors may increase the risk of both epilepsy and autism. We know both conditions have been linked to specific genetic disorders, including Rett Syndrome, fragile X syndrome, and tuberous sclerosis complex.

• Another underlying cause may increase the risk of both epilepsy and ASD. For example, environmental toxins could cause damage to the nervous system, which leads to both of these conditions.

These are not mutually exclusive ideas, meaning that more than one of them could be true. In fact, many experts believe that all of these mechanisms may contribute to the link between epilepsy and autism.

Can anti-epileptic drugs cause autism?

Studies have suggested an increased risk of ASD in children whose mothers were treated with certain anti-epileptic drugs while pregnant. 

A large-scale study⁴ in Norway found an increased risk of autism in children who had been exposed to the anti-epileptic drugs lamotrigine, valproate, or carbamazepine in utero. Other studies⁵ have confirmed that taking anti-epileptic drugs in pregnancy increases the risk of autism in the child.

What can parents look out for?

Epilepsy and ASD have some shared symptoms that might be confusing for parents. For example, some seizures cause repetitive, purposeless behaviors known as automatisms. Similar behaviors are common in children with autism. 

Other symptoms are similar as well. Children with both epilepsy and ASD can present with cognitive delay, impaired social interactions, and aggressive or irritable behavior. It’s important that you pay close attention so that your child receives the correct diagnosis. Some children with epilepsy could easily be misdiagnosed with autism.

Parents of children with ASD who are concerned about possible seizures can look out for the following symptoms in their child:

• Staring off into space as if daydreaming and not responding when spoken to

• Rapid eye blinking

• Stiffening of muscles

• Twitching or jerking movements

• Rhythmic movements, such as nodding the head

• Suddenly going limp

• Loss of bowel or bladder control (in a child who is toilet trained)

• Changes in breathing

• Loss of consciousness

If you notice these signs in your child, it’s important to bring them up with your child’s doctor. A medical evaluation using brain imaging and an electroencephalogram (EEG, a study that measures brain waves) can help to determine if your child has epilepsy. 

The lowdown

While it has been clear for some time that a connection exists between epilepsy and autism, scientists have yet to figure out the exact nature of this connection. Children with epilepsy are more likely to have ASD than children in the general population, and children with ASD are also more likely to have epilepsy.

When these two conditions occur together, this can make medical treatment more complicated. To ensure that your child receives the best possible medical care, they should receive treatment from medical specialists.