What is epilepsy and seizures?
Epilepsy is a condition that causes seizures this is due to an imbalance in brain chemistry so messages that travel between nerve cells or neurons become scrambled. A seizure is a burst of uncontrolled electrical brain activity between the brain cells common symptoms of this are stiffening or jerking of muscles, confusion, loss of consciousness, unusual thoughts or sensations.
Here are the most common types of seizures in individuals with autism:
- Generalised tonic-clonic seizures sometimes called generalised onset motor seizures– it affects both halves of the brain and causes both stiffening of muscles and twitching or jerking.
- Focal Onset Aware Seizures- they start in one area of the brain and may cause loss of awareness, or the person remain fully aware during the episode. This is the most common type of seizure for those who have epilepsy.
- Febrile seizures- this type of seizure happens to children aged 3 months to 6 years and they occur when the child has a high fever. This may be either a general or focal seizure. Sometimes this may lead up to the development of epilepsy.
Is there a link between autism and epilepsy?
Yes
20-40% of people with autism have epilepsy. Autistic people are more likely to develop epilepsy compared to those who are neurotypical and people with epilepsy are more likely to be autistic than those without. The risk of developing seizures increases as person gets older in life.
One theory suggests that the overlap in conditions may be because they share common biological mechanisms such as too much excitation brain which may stem from too little inhibition (an imbalance of the two). However, many experts remain sceptical about this theory despite the data to support this claim from a study published in 2003.
Other disorders related to involve seizures also involve seizures these include Landau-Kleffner Syndrome, Rett Syndrome, Angelman Syndrome and Tuberous sclerosis complex and Fragile X and many other syndromes.
Potential signs to look out for
It can be difficult to recognize seizure activity when the person is autistic this may be because of communication barriers and the overlap in symptoms of the two. Cognitive delay, impaired social interaction, aggression and irritable behaviour can be seen in children with epilepsy but also if in those who are autistic as well which makes it confusing to find the cause.
However, there are some red flags to note for seizure which may be useful:
- Staring episodes (could be a sign of absence or atypical absence seizures)
- Stiffening (could be a sign of tonic seizures)
- Rhythmic shaking or twitching (could be a sign of focal aware/simple partial seizures)
- Loss of attention (could be assign of absence or focal impaired awareness/complex seizures)
Atypical absence seizure– Starts in both sides of the brain and is unusual or different compared to typical absence seizures.
Absence seizures– Starts in both sides of the brain and causes a short period of “blanking out” or staring into spaces.
Focal onset impaired awareness seizure– Begins in one side of the brain and the person has a change in their level of awareness during some or all of the seizure.
Tips for managing epilepsy.
- Know that it could happen– making sure friends, family and carers are aware the possibility of epilepsy developing in someone with autism.
- Get a personalised plan– creating a plan with doctors can help family and healthcare professionals to manage the seizures.
- Regular medication– it’s important to medication as instructed if prescribed.
Identify triggers-not everyone has triggers before a seizure but common signs to look out for is being overtired, missing meals and forgetting to take epilepsy medication. Keeping a diary of seizures can help to see if there are any triggers.
- Avoid heavy drinking– heavy drinking can cause seizures and make medication less effective.
- Regular reviews– this is important as it can see if your treatment plan is going well. If you find doctors appointment there are many adaptions in place to make this experience less stressful like asking if there is a quiet room or asking to book the first or last appointment of the day, so you don’t have to wait too long for example.
- Safety checks– a safety check can help to identify and lower the risks before someone with epilepsy does an activity.
Side effects of anti-epileptic drugs (AEDs)
AEDs are the most common used treatment for epilepsy and can be quite effective as they can help to control seizures in around 7 out of 10 people. However, side effects are common when starting the treatment and may pass in a few days or weeks or may not appear for a few weeks.
Some common side effects of AEDs include:
- A lack of energy
- Agitation
- Headaches
- Drowsiness
- Uncontrollable shaking (tremors)
- Unwanted hair growth or hair loss
- Swollen gums
- Rashes – this could a sign of a serious reaction so you should contact your GP or specialist.
Disclaimer- The medical information presented here is just information, not medical advice and should be used for educational purposes. If medical advice is needed you should consult your GP or any other appropriate medical professional.
Sources
Autism and epilepsy: Is there a relationship?
The link between autism and epilepsy explained
A guide to managing epilepsy in autism
By Reneé
ATLAS Surrey 