Abstracts

Rationale: To characterize the frequency of first and second seizures in a group of children and adolescents with a clinical diagnosis of autism spectrum disorder (ASD). We also evaluated the mean age of initial seizure, occurrence of a second seizure, and choice of anti-epileptic medication (AED) therapy. Note that this is a non-selected clinical group and includes all symptomatic and idiopathic epilepsies. Methods: A retrospective search of the NorthShore University patient database was carried out by clinical informatics using the ICD-9 codes for autism, seizures and epilepsy after approval was obtained from the NorthShore Institutional Review Board. An Excel spreadsheet was prepared by the investigators. Data were abstracted from patient records and included: patient demographics, age of initial and second seizure, seizure description, initial and secondary AED and effectiveness, EEG, and neuroimaging with results (CT, MRI, and PET Scan). We classified the type of autism as unknown, idiopathic, symptomatic/genetic, or autistic regression. We also reviewed daily functionality (toilet trained, mobility, current language, feeding, and sleep) of each patient. Results: A total of 99 patients were identified; 21 patients did not meet inclusion criteria. Seventy-eight charts were reviewed. Mean age at time of chart review was 15.2 years. A total of 81% of patients are male; 91% are classified as Non-Hispanic. The majority of patients were diagnosed with autistic disorder, pervasive developmental disorder NOS, or autism spectrum disorder. Six patients were described as having autistic regression. The mean age of the initial seizure was 7.9 years; most frequent description was tonic-clonic. Seventy-two patients experienced a second seizure (72/78) occurring within a mean of 10.3 months. The choice of initial AED varied; the most frequently used were valproic acid, phenobarbital and lamotrigine. Conclusions: In this clinical cohort of children with ASD, first seizures were commonly seen before 10 years of age with a second seizure documented in 92% of patients. The choice of initial AED was variable.