Autism: Electroencephalogram Abnormalities and Clinical Improvement With Valproic Acid

Abstract

Autism is a severe disorder of social and communicative development. Although there are a number of biomedical causes of autistic symptoms,¹a cause has not been identified for the majority of children with this condition. There is a much higher prevalence of epilepsy and electroencephalographic (EEG) abnormalities in autistic children as compared with controls.^2,3However, it is not clear whether autistic children with epileptiform abnormalities on EEGs (spikes and/or sharp waves) who have never had seizures would benefit from anticonvulsants. In a comprehensive review of autism, Minshew et al⁴mentioned nonconvulsive seizures as a possible association with autism but recommended further testing and anticonvulsants only in those children with clinical indications of possible epileptic phenomena. More significantly, in a recent review of autism, Rapin⁵wrote: "There is little evidence to suggest that seizure-free children with rare spikes or other paroxysmal EEG discharges will benefit from anticonvulsants."