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Autistic people are, research has found, more likely to have epilepsy — and people with epilepsy are more likely to be autistic. What's the connection between these two?

Plenty of conditions are associated with autism, from gastrointestinal issues, Fragile X syndome, and tuberous sclerosis, to mental health struggles such as anxiety, post-traumatic stress disorder, and obsessive compulsive disorder, as well as ADHD. Epilepsy, too, seems to be more prevalent among autistic people. What is the connection here?

Autism and epilepsy: A brief overview

Though many people see autism as a behavioral condition marked by social deficits and repetitive actions and preferences, that's just what it looks like from the outside. These things are symptoms, as seen from the point of view of non-autistic people. What happens in the brain is different — and autism is, at its core, a neurological variation characterized by extremely high levels of synaptic connectivity and reactivity. The autistic brain is a highly excited one in which things are always going on. 

Epilepsy is, like autism, a spectrum — with many people talking about "epilepsies", plural. While epilepsy can manifest as anything from fairly benign to life-threatening, it's characterized by seizures in which normal brain activity is disrupted. Symptoms include muscle spasms, convulsions, and losing consciousness, but also unusual sensations and emotions. Like autism, epilepsy features an especially sensitive brain. 

Some research, including an extremely large Swedish study that included over 80,000 people, has suggested that autism and epilepsy have shared genetic risk factors — not only are people with epilepsy more likely to be autistic than those without, but so are their siblings and children. This connection was found to be especially strong in people diagnosed with epilepsy during early childhood. 

It's not clear how common epilepsy is in autistic people — but we do know it's more likely to strike autistics

Various studies have looked into the prevalence of epilepsy among autistic people, and come up with wildly varying results. Some studies found the rate of epilepsy in the autistic population to be only slightly higher than it is in the general population, but others found alarming rates of epilepsy among their participants. 

One large 2019 study that included over 7,000 autistic kids, for instance, found an epilepsy rate of approximately 10 percent. A study from a few years earlier found an even higher rate — 12.5 percent in autistic children under 13, and a shocking 26 percent in children over that age. No matter the exact rate of epilepsy in autistic people, one thing is clear. The CDC estimates that 1.2 percent of the general population have epilepsy, and people on the autism spectrum are more likely to have epilepsy. 

Autism and epilepsy: Which autistic people are most likely to be affected?

Currently available research suggests that epilepsy is more common in autistic people who have reached adolescence and are, according to one study, female. Co-occurring cognitive impairment, and lower language skills and adaptive skills are also more likely in autistic people with epilepsy. (In comparison, somewhere between 20 and 27 percent of people who live with epilepsy have some degree of intellectual disability, and some studies suggest that it's not autism itself that raises the risk of epilepsy, but rather autism plus intellectual disability.) It is possible that infantile spasms (a type of seizures) increase the risk of epilepsy, too. 

Some kinds of epilepsy, such as Landau-Kleffner syndrome, can also, however, lead to symptoms that can look a lot like autism, even though they aren't. It is, therefore, also necessary to consider that some people with epilepsy might have been misdiagnosed with autism. On the other hand, autistic people are also more likely to emit EEG discharges that may lead to a misdiagnosis of epilepsy. 

When should you see a doctor about possible epilepsy?

Epilepsy is an umbrella term, and symptoms can manifest in many different ways. Regardless of whether a person is autistic or not, a doctor should be consulted when:

  • The person exhibits uncontrolled jerky movements — this can be a sign of clonic seizures, but shouldn't be confused with stimming, repetitive movements common in autistic people that can include rocking, leg tapping, vigorous hand movements, and so on. 
  • The person's muscles suddenly turn stiff, especially those in the extremities and the back — this can be a sign of a tonic seizure. 
  • The person suddenly loses muscle tone and may fall down or drop their head, a possible sign of so-called atonic seizures. 
  • The person stares into space and exhibits muscle twicthes — a possible sign of absence seizures which, again, shouldn't be confused with normal autistic behaviors like stimming and just being in deep thought. 

These symptoms are reason enough to seek medical attention as soon as possible to rule epilepsy in or out. Following that, if epilepsy is diagnosed, anticonvulsant medications can help keep seizures under control. 

A final word

Much research has been done into the link between autism and epilepsy, and it's always ongoing — so if you are interested in learning more, always keep an eye out for the latest scientific discoveries. 

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