Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada; Department of Community Health Sciences, O'Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Epilepsy Behav. 2019 Sep;98(Pt A):238-248. doi: 10.1016/j.yebeh.2019.07.037. Epub 2019 Aug 6.
We aimed to review the literature to determine the incidence and prevalence of autism in epilepsy and epilepsy in autism, conditions that are often comorbid.
We adhered to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) standards, and the protocol was registered with PROSPERO. MEDLINE, Embase, PsycINFO, and the Cochrane Database of Systematic Reviews were searched from inception until July 4, 2016. Studies were included if they reported an incidence or prevalence of autism in epilepsy or epilepsy in autism. These estimates were described using mean, standard deviation, median, and interquartile range.
Seventy-four studies reporting on 283,549 patients were included. The median overall period prevalence of epilepsy in people with autism was 12.1% while the median overall period prevalence of autism in people with epilepsy was 9.0% when including all population types. When excluding studies that investigated patients with syndromic epilepsy or developmental delay, the median overall period prevalence of epilepsy in people with autism was 11.2% while the median overall period prevalence of autism in people with epilepsy was 8.1%. We observed trends for sex as the prevalence of autism in epilepsy was higher in males while the prevalence of epilepsy in autism was higher in females. It is important to interpret these estimates with caution, as there was significant heterogeneity between studies. Meta-regression found no association between study quality and prevalence or incidence estimates (all p-values > 0.05).
The period prevalence of epilepsy in people with autism, and vice versa, was consistently higher than previously reported estimates of the occurrence of these disorders in the general population. These findings highlight the importance of screening for autism in people who have epilepsy and epilepsy in people who have autism and may help shed light on shared pathogenesis between these conditions.
我们旨在回顾文献，以确定癫痫伴自闭症和自闭症伴癫痫的发病率和患病率，这两种疾病常同时存在。
我们遵循 PRISMA（系统评价和荟萃分析的首选报告项目）标准，并在 PROSPERO 上注册了方案。从开始到 2016 年 7 月 4 日，我们搜索了 MEDLINE、Embase、PsycINFO 和 Cochrane 系统评价数据库。如果研究报告了癫痫伴自闭症或自闭症伴癫痫的发病率或患病率，则纳入研究。这些估计使用平均值、标准差、中位数和四分位间距来描述。
纳入了 74 项研究，共涉及 283549 名患者。自闭症患者的总体期间癫痫患病率中位数为 12.1%，而包括所有人群类型在内，癫痫患者的总体期间自闭症患病率中位数为 9.0%。当排除研究中调查的综合征性癫痫或发育迟缓患者时，自闭症患者的总体期间癫痫患病率中位数为 11.2%，而癫痫患者的总体期间自闭症患病率中位数为 8.1%。我们观察到性别趋势，即癫痫伴自闭症的患病率在男性中较高，而自闭症伴癫痫的患病率在女性中较高。需要谨慎解释这些估计，因为研究之间存在显著的异质性。荟萃回归发现研究质量与患病率或发病率估计之间没有关联（所有 p 值均>0.05）。
自闭症患者的癫痫期间患病率，反之亦然，始终高于以前报告的这些疾病在普通人群中发生的发生率。这些发现强调了在癫痫患者和自闭症患者中筛查自闭症的重要性，并且可能有助于揭示这些疾病之间的共同发病机制。
