Are Autism and Epilepsy Related ?

There are numerous conditions when it comes to mental and psychological health. These include conditions such as bipolar disorder, depression, anxiety, attention deficit hyperactivity disorder, pschizifrenia, and many other conditions. Here we ask are autism and epilepsy related ? For those unaware of what either condition is, autism is a developmental condition in which the individual may be a little slow concerning learning, have an extreme anti social personality disorder, be withdrawn, and other factors as well. Epilepsy is a medical condition in which due to different triggers, the brain is not able to hold what would be considered a normal frequency of neurotransmitters. Unless controlled, the result is the equivalent of what would be a thunderstorm in the brain. Epilepsy is more physiological, although there have been incidences in which they can be caused by psychotic symptoms. These are referred to as psychogenic non epileptic seizures. The relationship between these two conditions is look at, including some studies that have been conducted.

Many individuals that know or know of someone with autism or Asperger syndrome which is a higher functioning form of autism probably take them to be a mild case of MR or what was once known as mental retardation. This is not the case though. Although an individual that has autism may have a lower IQ than what would be considered normal, they are smart in some specific ways. One of the main factors of autism is that of the individual having a low level of social interaction and lacking communication skills. The main way to determine autism would probably be to perform an IQ test on the individual since many individuals may have anti social symptoms which could come from other factors.

Concerning the relationship between autism and epilepsy, there are many questions that can be asked, although many there are still no answer to. These questions include: knowing whether one of these conditions causes the other, whether specific brain mechanics may be common in both, knowing the role of genetics, and even if the periods of pregnancy concerning the environment may be a factor.

Although these conditions are separate, is the co-occurrence of them together by chance, or it could have to do with the same genetic disorder or cerebral damage ? Each condition may have some genetic abnormality, but it is unknown if it is the same for both in those only with epilepsy, and those which had both epilepsy and autism. It is known though that epilepsy in those with autism can be determined by a specific genetic condition, or structural alterations (4) Through some studies, it has shown that epilepsy can rarely be the cause of autistic features, and is not the cause of autism in most cases, as well as there being no evidence that autism can cause epilepsy (3) Although when these two conditions are looked at separately, there is strong evidence for both arising from genetic investigation (3) whether the specific genetic structure in those with only epilepsy is similar to those with both epilepsy and autism is yet to be found.

Concerning autism spectrum disorder, there are numerous symptoms that an individual shows prior to being diagnosed. The diagnosis of this condition normally happens in childhood as well. These include things such as core social dysfunction, rigid and repetitive behaviors, as well as restricted interests, all of which are symptoms of the onset of autism (4). Concerning the relationship between the two conditions, each occurs separately.

One study looked to establish the occurrence of epilepsy among children with autism, defining the types of seizures and syndromes, the onset age of epilepsy. In this study 59 patients were looked at. These patients were from age 1 to 18 which had been diagnosed with autism and took place over 5 years. Detailed medical history was used. It was shown that the onset of epilepsy was diagnosed before the age of 7. Concerning the type of seizures seen, focal seizures were the most common. Therapeutic responses to seizures was good, with 58% being seizure free, and 27% having a greater than 50% frequency in seizure decrease. No improvement in autistic behavior was seen though. No correlation between epilepsy and occurrence of degree of ID was seen, but there was a correlation between frequency of epileptic seizures and degree of ID. Overall there was a significant percentage of epilepsy in the autistic population. These can be treated specifically based on the gene defect that is involved (1). This allows for specific treatments to be used based on the individuals condition.

It has been said that autism caused by epilepsy could be a process that interferes with the function of a specific network of the brain which may be involved in the development of communication skills and social behavior, while autism may also be the result of a withdraw reaction in an epileptic child. (2) In some ways to a point this may make sense. If an individual has epilepsy and it is at a very intense level, any scarring left over time on specific areas of the brain may lead to specific dysfunctions of that region of the brain. These areas may control things such as communication and social behavior. This would be autism being brought on indirectly by epilepsy, although more research needs to be done.

An example concerning this relationship could be as follows. An individual only known to have epilepsy may have a high IQ and have extrovert tendencies prior to the situation worsening. When one’s frequency of seizures increase, or the intensity increases, this can lead to other changes such as an issue with finding employment, the inability to drive, as well as other conditions. This includes a possible decrease in self-esteem or confidence. This in turn may lead to issues concerning one’s’ level of communication and overall interaction with others. Although not intentionally, this would be a form of anti social behavior which is a feature of autism. This is one thing that the two conditions would have in common. Although there is truth to this, the condition itself for one with only epilepsy is situational, and change should happen over time. This would develop back into more of a normal social able behavior being re established.

There are many factors concerning the relationship between epilepsy and autism. Physiologically speaking, the main factor among these two conditions may be the gene defect concerning autism. No common gene defect has been found between epilepsy and autism, although this is still a possibility. Until research says otherwise genetically speaking these conditions probably come from different places.
The other question that should be looked at is that of excessive scarring due to epilepsy over time possibly being a risk factor to develop autism. This may be due to specific parts of the brain being effected. Overall, when you consider only the outward symptoms of these two conditions it may be hard to discern differences between the two in some cases. Physiologically speaking more research needs to be done to determine any connection between the development of these two conditions.

1. Epilepsy in children with autistic spectrum disorder. Children, 2019 Jan 23 6 (2)

2. Epilepsy and autism disorders in children

3. Current controversies in the relationship between autism & epilepsy: Epilepsy behavior, 2015 Jun 47 143-146

4. Autism, Epilepsy, & synaptopathies: A not rare association.  Neurological Sciences 2017 Aug 38 (8) 1353-61