Department of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio;
Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Pediatrics. 2020 Apr;145(Suppl 1):S117-S125. doi: 10.1542/peds.2019-1895O.
Children with autism spectrum disorder (ASD) have a higher prevalence of epilepsy compared with general populations. In this pilot study, we prospectively identified baseline risk factors for the development of seizures in individuals with ASD and also identified characteristics sensitive to seizure onset up to 6 years after enrollment in the Autism Speaks Autism Treatment Network.
Children with ASD and no history of seizures at baseline who either experienced onset of seizures after enrollment in the Autism Treatment Network or remained seizure free were included in the analysis.
Among 472 qualifying children, 22 (4.7%) experienced onset of seizures after enrollment. Individuals who developed seizures after enrollment exhibited lower scores at baseline on all domains of the Vineland Adaptive Behavior Scales, greater hyperactivity on the Aberrant Behavior Checklist (25.4 ± 11.8 vs 19.2 ± 11.1; = .018), and lower physical quality of life scores on the Pediatric Quality of Life Inventory (60.1 ± 24.2 vs 76.0 ± 18.2; < .001). Comparing change in scores from entry to call-back, adjusting for age, sex, length of follow-up, and baseline Vineland II composite score, individuals who developed seizures experienced declines in daily living skills (-8.38; 95% confidence interval -14.50 to -2.50; = .005). Adjusting for baseline age, sex, and length of follow-up, baseline Vineland II composite score was predictive of seizure development (risk ratio = 0.95 per unit Vineland II composite score, 95% confidence interval 0.92 to 0.99; = .007).
Individuals with ASD at risk for seizures exhibited changes in adaptive functioning and behavior.
自闭症谱系障碍（ASD）患儿的癫痫发病率高于普通人群。在这项初步研究中，我们前瞻性地确定了 ASD 个体发生癫痫的基线风险因素，并且确定了在入组自闭症治疗网络后 6 年内对癫痫发作敏感的特征。
本研究纳入了基线时无癫痫发作史且在入组自闭症治疗网络后出现癫痫发作或未发生癫痫发作的 ASD 患儿。
在符合条件的 472 名儿童中，有 22 名（4.7%）在入组自闭症治疗网络后出现癫痫发作。与未发生癫痫发作的个体相比，入组后发生癫痫发作的个体在所有 Vineland 适应行为量表领域的基线评分均较低，在异常行为检查表上的多动评分较高（25.4 ± 11.8 与 19.2 ± 11.1； =.018），儿科生活质量量表的身体生活质量评分较低（60.1 ± 24.2 与 76.0 ± 18.2； <.001）。比较入组至随访期间的评分变化，调整年龄、性别、随访时间和基线 Vineland II 综合评分后，发生癫痫发作的个体的日常生活技能下降（-8.38；95%置信区间 -14.50 至 -2.50； =.005）。在调整基线年龄、性别和随访时间后，基线 Vineland II 综合评分可预测癫痫发作的发生（风险比为每单位 Vineland II 综合评分降低 0.95，95%置信区间为 0.92 至 0.99； =.007）。
有癫痫发作风险的 ASD 个体表现出适应功能和行为的变化。
