Staring Spells in Children with Autism Spectrum Disorder: A Clinical Dilemma
Abstract number :
1.205
Submission category :
4. Clinical Epilepsy / 4B. Clinical Diagnosis
Year :
2022
Submission ID :
2203969
Source :
www.aesnet.org
Presentation date :
12/3/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:22 AM
Authors :
Ajay Goenka, MD – Dayton Children's Hospital; Laura Fonseca, MS – Dayton Children's Hospital; Monica George, MSII – Wright State University Boonshoft School of Medicine; Gogi Kumar, MD – Dayton Children's Hospital; Sarah Yu, MSII – Wright State University Boonshoft School of Medicine
Rationale: Staring spells in children with autism spectrum disorder (ASD) is a common clinical presentation. The workup and management of staring spells in children with ASD is challenging due to varied clinical presentation, difficulty in obtaining history, sensory issues in performing physical examination and in conducting EEG studies. However, since the median overall period prevalence of individuals with ASD and epilepsy is estimated to be 12.1%, greater than the prevalence in the general population, it is prudent to rule out seizures as a cause of staring spells. The aim of this study is to assess the prevalence of epilepsy in children with ASD who present with suspicion for seizures characterized by staring spells._x000D_
Methods: A retrospective chart analysis was performed at a tertiary care children’s hospital from January 2010 to January 2021. The study included patients aged 3 to 14 years with a diagnosis of ASD, who were referred to neurology for staring spells. Patient information was collected through chart review and included demographics, clinical presentation, comorbidities, and final diagnosis. Target episodes of staring spells were captured during a long-term EEG monitoring record. _x000D_
Results: A total of 140 patients with ASD were included in the final analysis based on the inclusion criterion. Amongst the cohort, 16% (22/140) were diagnosed with epilepsy based on the long-term EEG monitoring. Clinical semiology differentiating epileptic spells vs. non-epileptic spells included average duration of episodes of 42 seconds vs. 87 seconds, frequency of spells every week 6 vs. 11.5, increase in frequency of the spells 100% (22/22) vs. 40% (47/118) and response to verbal stimulation 0% (0/22) vs. 100% (118/118) respectively. Interictal EEG abnormalities were seen in 100% (22/22) of epilepsy patients with ASD vs. 73% (86/118) in the non-epileptic ASD group._x000D_
Conclusions: Staring spells in children with ASD can have varied presentation. Clinical features can be helpful in differentiating seizures from non-epileptic etiology. Long term EEG monitoring to capture and characterize these spells remains the most reliable tool to rule out epilepsy._x000D_
Funding: None
Clinical Epilepsy