Introduction: Epilepsy occurs at an increased rate in children with various neurodevelopmental disorders, with poorly controlled seizures playing a role in their cognitive functioning. We studied the prevalence and associated factors of Epilepsy and Inter-ictal Epileptiform discharges (IED) in children with Autistic Spectrum Disorders (ASD) and Attention-deficit Hyperactivity Disorder (ADHD).

Methods: Children between 6-12 years attending a public hospital in India were evaluated for ASD and ADHD as per DSM-5. Childhood Autism Rating Scale and Conner’s Rating Scales were used to assess the severity and sub-classify children with ASD and ADHD, respectively. Intelligence Quotient was assessed. History of seizures was taken, and Electroencephalography was done in all children. Epilepsy was diagnosed and classified according to ILAE, 2017.

Results: Of the 130 children enrolled (90 ASD, 40 ADHD), 56 (43%) had epilepsy and 55 (42.3%) had Inter-ictal epileptiform discharges (IED). The proportion of both epilepsy and IED was higher among ASD (both 45.5%) as compared to ADHD (37.5% and 35%), although not statistically significant. Among children with ASD, epilepsy was common in those with severe ASD (P<0.001), and IEDs were more common in those with IQ<80 (P=0.047). There were no significant differences between occurrence of epilepsy/IED and subtypes of ADHD.

Conclusions: The high prevalence of epilepsy and IED among children with ASD and ADHD emphasizes the need for guidelines for identifying and diagnosing epilepsy in this group, so as to ensure appropriate management and improved patient outcomes.