Tuesday, 8 October 2013

Epilepsy, Autism & EEGs

It is widely known that autism and epilepsy are comorbid with each other. Statistics are not very consistent, but it appears that up to 35% of people with autism will develop epilepsy and something like 30% of people with epilepsy already have autism.

My interest in epilepsy is currently just as a comorbidity, since Monty, aged 10 with ASD, has not exhibited any signs of it.  I will refer back to epilepsy in later posts when I attempt to “validate” potential autism interventions.  My logic is that if something has a positive effect across the majority of comorbidities, then I may be on to something.  For example, I found it insightful to read in a small study that nicotine patches reduced the incidence of epileptic attacks by 50%.
I recently came across an excellent, highly readable, paper that I think all parents interested in ASD should read.  It is written by an Israeli lady who is also doing some other very thoughtful research into treating autism.  The research itself is a retrospective study of EEG (Electroencephalography) tests on 56 children done in the US.
EEG testing is known to be very insightful, but due to cost and availability, is rarely used in autism.  Some children, diagnosed with autism, turn out to have something different.

 Here are some highlights:
·        About 10% of children given a diagnosis of autism are found to have either a paroxysmal EEG pattern, as seen in acquired epileptic aphasia (Landau–Kleffner syndrome), or electrical status epilepticus during sleep, as seen in some children with childhood disintegrative disorder. 

·        None of the children who presented with ‘‘unlikely symptoms,’’ such as febrile convulsions, breath holding spells, and rage episodes, were diagnosed with epilepsy  

·        As many as 40% of the total group with autism had epilepsy, which was symptomatic in most children. Half of the children presented with convulsions, and they all had abnormal electroencephalograms (EEG) and were diagnosed with epilepsy.  

·        About one-quarter of the children presented with staring episodes, half of whom had epilepsy. 

·        None of the children with episodes of rage or breath holding spells had epilepsy 

o   This is the opposite of what many experts assume 

·       Our results, which indicate that clinical suspicion for epilepsy should be high if there is a history of convulsion and staring episodes, are in agreement with other studies showing that nearly all autistic children with seizures also exhibit epileptiform activity on electroencephalograms

A short film

Here is a parent-made film, showing the EEG procedure.


If you live in an area where EEGs are on offer, (California seems to be one good place to live) then it looks like a very smart test to have done.  If you were thinking your child’s tantrums and raging were indicative of future epilepsy, you can breathe again. 



  1. Hello Peter,

    I have a simple, probably naive query. Have changes in EEG been recorded following administration of bumetanide..from subclinical abnormalalities to a more normalised pattern.

    1. That is a good question, but best directed to the researchers who are developing bumetanide as an approved drug. Their website is

    2. This comment has been removed by the author.

    3. Hi Peter,

      Actually I was searching on the net for parental reports on changes in EEG readings, a before and after sort of thing, following bumetanide use. I am sure some parent readers of this blog must have recorded these observations. Do you recall any mention of this.


    4. Hello Peter,

      Yes, few case studies as well as research articles are there on effect of bumetanide on EEG readings. However, some seem inconclusive, some even contradictory, and although bumetanide could prevent seizure activities in certain kinds of epilepsies, its much touted use as an anti epileptic drug in neo nates was also up for question.

      The learning center I take my son to is also visited by a paed-gynae couple with a severely affected, profoundly delayed son suffering from seizures. I just thought if i can lay my hands on something solid I could discuss it with them although they seem very uptight and probably mighy have already tried out all these interventions without any productive outcome.

    5. I've encountered a problem to post a comment, so maybe you need to delete the previous one.

      There's a case report about a girl treated with Bumetanide in the Netherlands:

      "The treatment resulted in a marked clinical improvement in sensory behaviors, rigidity, and memory performance, which was substantiated by questionnaires and cognitive assessments. At baseline, the girl’s EEG showed a depression in absolute alfa power, an electrographic sign previously related to ASD, which was normalized with bumetanide treatment".

      To some degree it is similar to what I saw in my son's EEG early on Bumetanide. It relates to awake EEG and translaing this 'dark art' to something more understandable to myself it means: less encephalopathic and less immature.

      Bumetanide did not reduce his epileptiform discharges on sleep EEG (which is a common pattern in autism), at least in first few weeks of treatment. We just came back from EEG yesterday, so I can post some new data soon.

      I might be mistaken, but I recall children in French Bumetanide study had EEG done before the trial and these with epilepsy were not included. So this group probably could not explain much about Bumetanide influence on epileptiform EEG.

    6. Hi Angeiszka,

      Yes, I had gone through the Netherlands case study. If I remember correctly, bumetanide was not able to alter seizure frequency in the girl although remarkable improvements in mental development were observed.

      As you explained, a reduction in alpha power of EEG reading would be indicative of a less diseased and better developed brain.

      And yes, epileptic individuals were not included on the French study.

      Thanks for interpreting the heavy EEG terminology.

    7. Hi Angeiszka,

      Sorry I think I overlooked..

      your son's EEG readings also showed a pattern similar to the girl following bumetanide use. And he did improve cognitively.

      As far as spikes in EEG readings recorded during sleep, even your medical community is devided if minor aberrations, so common in autistic kids, is indicative of a higher probability of developing seizures in future

      Thank you so much for your response and as always best wishes for your son.


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