Article

A systematic review of two outcomes in autism spectrum disorder - Epilepsy and mortality

University of New South Wales, Randwick, Sydney, NSW, Australia.
Developmental Medicine & Child Neurology (Impact Factor: 3.29). 02/2012; 54(4):306-12. DOI: 10.1111/j.1469-8749.2012.04223.x
Source: PubMed

ABSTRACT It has been reported that rates of epilepsy and mortality are higher among the population with autism spectrum disorder (ASD) than in the general population. The aim of this systematic review is to provide comprehensive evidence for clinicians, carers, and people with ASD regarding these outcomes.
Studies were eligible for inclusion if the main focus of the study involved observation over a period of 12 months or more of an initially defined population (with appropriate diagnostic label). Studies were also required to have at least 30 participants in order to differentiate case series from cohort studies. The Cochrane Database of Systematic Reviews, the Database of Reviews of Effectiveness, MEDLINE, PsycINFO, EMBASE, and CINAHL were searched. The date of the last search was September 2010. The risk of bias of included studies was assessed and a meta-analysis was undertaken.
Twenty-one studies were identified, 16 measuring the percentage of participants with epilepsy and five measuring mortality using a standardized mortality ratio. The pooled estimate for the percentage of participants with epilepsy was 1.8% (95% CI 0.4-9.4%) in studies in which the majority did not have an intellectual disability and the mean age was <12 years at follow-up, and 23.7% (95% CI 17.5-30.5%) in studies in which the majority did have an intellectual disability and the mean age at follow-up was more than 12 years. The pooled estimate for the standardized mortality ratio was 2.8 (95% CI 1.8-4.2).
The prevalence of epilepsy is higher among the population with ASD than in the general population. People with ASD have a higher risk of mortality than the general population. This has important health promotion implications.

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    • "Previous reviews have reported that the prevalence of epilepsy in ASD varies from 8 to 30 % (Spence and Schneider 2009; Tuchman et al. 2010). The variation is due to factors such as coexistent intellectual disability (ID) (Amiet et al. 2008; Mouridsen et al. 2011a, b; Woolfenden et al. 2012), female gender (Amiet et al. 2008; Danielsson et al. 2005), severe language dysfunction (Tuchman et al. 1991), and age (Giovanardi-Rossi et al. 2000; Hara 2007; Volkmar and Nelson 1990), which are all associated with the risk of epilepsy in ASD. Also, epilepsy is more common among subjects with childhood autism (Danielsson et al. 2005; Mouridsen et al. 2011a) or pervasive developmental disorder—not otherwise specified (PDD-NOS) (Challman et al. 2003; Mouridsen et al. 2011b; Parmeggiani et al. 2007) than subjects with Asperger's syndrome (Cederlund and Gillberg 2004; Mouridsen et al. 2013). "
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