Early diagnosis followed by treatment with anti-epileptic medications reduced the frequency of seizures and behavioral problems in three children with both Dravet syndrome and autism spectrum disorder (ASD), a study reports.
The study, “Epileptic Encephalopathy and Autism: A Complex Interplay,” was published in the Journal of Pediatric Neurosciences.
ASD is a neurological and developmental disorder characterized by communication and behavioral impairments. The condition develops early during childhood, and it is estimated that between 10.3% and 72.4% of children with the disorder show signs of abnormal brain activity, and 5%-46% have epilepsy, a chronic neurological disorder characterized by sudden bursts of brain activity that cause recurrent seizures.
Epileptic encephalopathies are neurological syndromes where brain deterioration is thought to be caused by frequent seizures and abnormal brain activity.
Dravet syndrome is a rare type of drug-resistant epileptic encephalopathy that frequently presents with hyperactivity behavior and other autistic features.
In this study, authors reviewed three cases of children diagnosed with both ASD and Dravet syndrome, who had their first seizures before they were a year old and failed to respond to first-line treatment with anti-epileptic therapies. The children all exhibited autistic features and behavioral issues.
Administration of a combination of anti-epileptic medications reduced the frequency of seizures and behavioral issues in all three children. These therapies included valproate (Depacon), clobazam (Onfi), oxcarbazepine (Oxtellar XR, Trileptal), and levetiracetam (Keppra, Keppra XR, Roweepra, Spritam, Roweepra XR).
Moreover, the anti-epileptic medications did not have a negative impact on the cognition of these children, contrary to the current belief that the “use of [antiepileptic drugs] have adverse impact on the cognition of children with early onset of epilepsy,” the authors wrote.
The team also found evidence that children with autism may benefit from primary treatment approaches such as occupational therapy, special education, speech therapy, and behavioral therapy. However, they highlighted that early diagnosis coupled with an aggressive treatment should also be included to improve behavioral outcomes.
“Rapid and aggressive treatment of epilepsy in the children with autism may be associated with better developmental outcomes,” they wrote. “Early diagnosis followed by treatment with [anti-epileptic drugs] can improve seizures and EEG [epileptiform electroencephalography] abnormalities.”