Abstracts

Children with autistic spectrum disorder (ASD) are commonly referred for video-EEG monitoring to determine the precise nature of their seizure-like events. We studied 29 autistic children using continuous video-EEG telemetry monitoring at a tertiary care referral center. Of the 29 total patients, 18 were primarily referred for seizure evaluation and 9 for 24-hour interictal EEG recording. Studies were prematurely terminated in 2 patients who could not tolerate the procedure; mean duration of monitoring in the remaining 27 was 3 days. Of 18 children referred for seizure evaluation, 11 had recorded events, but none were epileptic seizures (seven had no recorded events). Interictal epileptiform EEG abnormalities were detected in 14 of 27 patients. These abnormalities included: focal sharp waves (in 5 patients), multifocal sharp waves (in 6 patients) and generalized spike-wave complexes (in 8 patients). Focal/multifocal and generalized epileptiform abnormalities co-existed in five children. Notably, seven of the 11 patients with non-epileptic events had interictal epileptiform EEG abnormalities. Video-EEG evaluation of children with ASD reveals epileptiform EEG abnormalities in the majority. However, most recorded seizure-like events are not epileptic, even in children with epileptiform EEG abnormalities.