Steffenburg Suzanne, Steffenburg Ulf, Gillberg Christopher
Department of Child and Adolescent Psychiatry, Göteborg University, Kungsgatan 12, SE-411 19 Göteborg, Sweden.
Dev Med Child Neurol. 2003 Nov;45(11):724-30. doi: 10.1017/s0012162203001361.
The aim of this study was to examine the comorbidity pattern, seizure characteristics, and aetiology in a representative group of children with a combination of autism spectrum disorder (ASD), active epilepsy, and learning disability. Ninety children (47 males, 43 females; mean age 11 years 2 months, range 8 to 16 years at the time of psychiatric examination) with active epilepsy and learning disability, identified in a population-based study in Göteborg, Sweden, were subdivided into those with and those without ASD and compared with respect to aetiology, additional neuroimpairments, and seizure characteristics. In addition, the cohorts were examined for trends of prevalence over a period of time. Results indicated that established aetiology was much more often present in the prenatal period than in the peri- or postnatal periods in the ASD group. Cerebral palsy and visual impairment were under-represented in the ASD group. Partial seizures tended to be more common and generalized seizures less common in the ASD group compared with the non-ASD group. Seizure onset was later in the ASD group. Many of the significant differences were accounted for by a large group of psychiatrically unclassifiable participants in the non-ASD group. There was no trend towards an increase of affected children over the 12-year period. There was no increase in the prevalence of active epilepsy and learning disability nor in the rate of autism with active epilepsy and learning disability in children born between 1981 and 1986 compared with those born from 1976 to 1980, indicating no statistical association with the general measles-mumps-rubella vaccination introduced in the early 1980s.
本研究旨在调查一组具有代表性的、患有自闭症谱系障碍(ASD)、活动性癫痫和学习障碍的儿童的共病模式、癫痫发作特征及病因。在瑞典哥德堡进行的一项基于人群的研究中,确定了90名患有活动性癫痫和学习障碍的儿童(47名男性,43名女性;精神科检查时平均年龄为11岁2个月,范围为8至16岁),将其分为患有ASD和未患有ASD的两组,并就病因、其他神经损伤和癫痫发作特征进行比较。此外,还对这些队列在一段时间内的患病率趋势进行了研究。结果表明,在ASD组中,已确定的病因在产前时期出现的频率远高于围产期或产后时期。ASD组中脑性瘫痪和视力障碍的比例较低。与非ASD组相比,ASD组中部分性癫痫发作往往更为常见,全身性癫痫发作则较少见。ASD组的癫痫发作起病较晚。非ASD组中一大群无法进行精神科分类的参与者导致了许多显著差异。在这12年期间,受影响儿童没有增加的趋势。与1976年至1980年出生的儿童相比,1981年至1986年出生的儿童中活动性癫痫和学习障碍的患病率以及伴有活动性癫痫和学习障碍的自闭症发病率均未增加,这表明与20世纪80年代初引入的常规麻疹-腮腺炎-风疹疫苗接种没有统计学关联。