Luz-Escamilla Laura, Morales-González José Antonio
Laboratorio de Medicina de Conservación y Maestría en Ciencias de la Salud, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón S/N, Col. Casco de Santo Tomás, Alcaldía Miguel Hidalgo CP 11340, México.
Departamento de Higiene Mental, Hospital General Centro Médico Nacional "La Raza", Instituto Mexicano del Seguro Social, Distrito Federal CP 02990, México.
Brain Sci. 2019 Jul 30;9(8):185. doi: 10.3390/brainsci9080185.
It has been reported that bioelectric alterations in an electroencephalogram (EEG) may play an etiological role in neurodevelopmental disorders. The clinical impact of interictal epileptiform discharges (IEDs) in association with autistic spectrum disorder (ASD) is unknown. The Autism Diagnostic Interview-Revised (ADI-R) is one of the gold standards for the diagnosis of autistic spectrum disorder. Some studies have indicated high comorbidity of IED and ASD, while other studies have not supported an association between the central symptoms of autism and IED. This review examines the high comorbidity and clinical impact of IED; patients with epilepsy are excluded from the scope of this review. ASD can be disabling and is diagnosed at an average age of 5 years old, at which point the greatest neurological development has occurred. If an association between IED and ASD is identified, a clinical tool that entails an innocuous procedure could enable diagnosis in the first years of life. However, in the absence of reports that prove an association between IED and ASD, patients should not be subjected to expensive treatments, such as the administration of anticonvulsant therapies.
据报道，脑电图（EEG）中的生物电改变可能在神经发育障碍中起病因学作用。发作间期癫痫样放电（IEDs）与自闭症谱系障碍（ASD）相关的临床影响尚不清楚。《自闭症诊断访谈修订版》（ADI-R）是诊断自闭症谱系障碍的金标准之一。一些研究表明IED与ASD的共病率很高，而其他研究则不支持自闭症的核心症状与IED之间存在关联。本综述探讨了IED的高共病率及其临床影响；癫痫患者被排除在本综述范围之外。ASD可能会导致残疾，其平均诊断年龄为5岁，此时神经发育最为显著。如果确定IED与ASD之间存在关联，那么一种采用无害程序的临床工具将能够在生命的最初几年进行诊断。然而，在没有报告证明IED与ASD之间存在关联的情况下，不应让患者接受昂贵的治疗，如抗惊厥治疗。
