Individuals with epilepsy are at increased risk of autism

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Individuals with epilepsy are at increased risk of autism (ASD), especially if their epilepsy appears in childhood, say Swedish researchers

The team identified 85,201 individuals with epilepsy from the Swedish Patient Register, as well as their siblings (80,511) and offspring (98,534). Each individual with epilepsy was compared with five controls, matched for age, sex, calendar period, and county, while siblings and offspring were compared with siblings and offspring of controls. Siblings and offspring with epilepsy were excluded from the study.

During a six-year follow-up, 1,381 (1.6%) individuals with epilepsy and 700 (0.2%) controls were diagnosed with ASD.

The study concluded that individuals with epilepsy were therefore at increased risk of future ASD, with the highest risk seen in individuals diagnosed with epilepsy in childhood. They also found that both siblings and offspring of epilepsy patients were at increased risk of ASD and that the risk in the offspring was particularly high in mothers with epilepsy.

As ASD is more common in the siblings and offspring of individuals with epilepsy, the findings also support the view that epilepsy and ASD have a shared etiology.

Commenting on the study Professor Sanjay Sisodiya, director of genomics at the Epilepsy Society, said:

The relationship between epilepsy and autism is poorly understood. We know that about 30 per cent of people with a mild to moderate learning disability also have epilepsy and that this risk increases, the more severe the learning disability. Similarly, around 20 per cent of those with epilepsy also have a learning disability.

There is much hope that the power of genetics will give us greater insight into how diseases start and develop, and the complex relationship between different diseases. This is very much the case with epilepsy and autism.

The study shows the need for new screening techniques that will lead to a better understanding of the relationship between different conditions and the need to adopt a holistic approach to healthcare. Wherever possible, different diseases should not be treated in isolation but as part of an integrated care plan.

Lead author, Dr Heléne Sundelin, also told Epilepsy Research UK:

The risk of autism for siblings and children to individuals with epilepsy are, despite the increase, still rather low. These results are more important for the understanding of the relationship between the disorders and should not be crucial when deciding to become a parent.

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