Carod F J, Prats J M, Garaizar C, Zuazo E
Servicio de Neuropediatria, Hospital de Cruces, Barakaldo, Vizcaya.
Rev Neurol. 1995 Nov-Dec;23(124):1203-7.
With the aim of ascertaining the existence of medical conditions associated with autism, the presence of pre- and perinatal factors, family antecedents as well as the prevalence rate of different epileptic syndromes in the juvenile autistic population, we carried out a retrospective observational study and looked at the medical history of 62 autistic children so diagnosed in the neuropaediatric service at Barakaldo Hospital Cruces in the past twenty years. All of them were diagnosed by a child neurologist following DSM-III-R criteria, having been by the same physician on at least one occasion. From the etiologic point of view, eight children (13%) presented specific syndromes, fifteen (23%) presented encephalopathies acquired pre-or perinatally, two (3.2%) had brain tumours and the remaining thirty-seven (61%) presented critogenetic autism. 47% of autistic children were seen to have some kind of epileptic syndrome: six had idiopathic epilepsy (juvenile myoclonic epilepsy 1: partial benign epilepsy with Rolandic point 2 ; petit mal 1; generalised primary epilepsy grand mal type 1); eleven had cryptogenic epilepsy (myoclonic epilepsy 1 ; focal 7; grand mal 1; Lennox 2) and secondary epilepsy in eleven other cases (West 4; focal 6; grand mal). In the literature an epileptic frequency among autistic subjects is quoted as being between 16% and 35% dropping to 6% in slight cryptogenic autistic cases. Our frequency rate among autistic children is much higher, reaching 47% of the total and affecting 46% of cryptogenic autistic cases. There were no cases of polymorphic nursing epilepsy in our series. Idiopathic and cryptogenic epilepsy were more frequent in cryptogenic autism.
为了确定与自闭症相关的医学状况的存在、产前和围产期因素、家族病史以及青少年自闭症人群中不同癫痫综合征的患病率,我们进行了一项回顾性观察研究,并查看了过去二十年来在巴拉克aldo医院克鲁斯神经儿科服务中被诊断为自闭症的62名儿童的病史。他们均由儿童神经科医生根据DSM - III - R标准进行诊断,且至少有一次是由同一位医生诊断。从病因学角度来看,8名儿童(13%)患有特定综合征,15名(23%)患有产前或围产期获得性脑病,2名(3.2%)患有脑肿瘤,其余37名(61%)患有原发性自闭症。47%的自闭症儿童被发现患有某种癫痫综合征:6名患有特发性癫痫(青少年肌阵挛性癫痫1例;伴有中央颞区棘波的儿童良性癫痫2例;失神发作1例;全身性原发性癫痫大发作型1例);11名患有隐源性癫痫(肌阵挛性癫痫1例;局灶性7例;大发作1例;Lennox综合征2例),另有11例为继发性癫痫(West综合征4例;局灶性6例;大发作)。文献中引用的自闭症患者癫痫发生率在16%至35%之间,在轻度隐源性自闭症病例中降至6%。我们研究中自闭症儿童的发生率要高得多,达到总数的47%,且影响了46%的隐源性自闭症病例。我们的系列病例中没有多形性护理癫痫的情况。特发性和隐源性癫痫在隐源性自闭症中更为常见。