Purpose: The prevalence of epilepsy in children with Autistic Spectrum Disorder [ASD] is variable as much as 5–38%. It remains unclear whether seizures are causative or co morbid to ASD. This study addresses prevalence of seizures and electroencephalographic [EEG] abnormalities in children with ASD.

Methodology: Cross sectional retrospective analysis was done from case record forms of 550 cases of ASD seen over 7 years at neurodevelopmental clinic of tertiary care hospital. Diagnosis of ASD was done by DSM IV criteria. Epileptic disorders were diagnosed on history and EEG abnormalities. ILAE classification was applied to classify seizures and epileptic syndromes.

Results:

Among 550 cases of ASD, 126 children [22.9%] had epilepsy or abnormal EEG. Abnormal EEG without convulsive manifestations was found in 18 [3.27 %] children. Among remaining 108 [19.63%] epileptic ASD children 30 [5.45%] had refractory epilepsy including West syndrome 7[1.27%],Lenaux Gastaut Syndrome 2 [0.36%], Severe myoclonic epilepsy 7 [1.27%] and epileptic encephalopathy 14 [2.54%]. Remote symptomatic epilepsy was diagnosed in 24 [4.36 %] children with severe autism. Febrile seizures 23 [4.18%] and single unprovoked seizures 25 [4.54%] were more common in children with mild autistic features.

Conclusion – Wide and variable spectrum of EEG abnormalities and seizure phenotypes can coexist with ASD. This association should not be ignored as understanding potential commonalities of the pathophysiology of both ASD and epilepsy may offer excellent windows for treatment and clinical improvement.