Autism and Epilepsy – What’s the Link?

Autism Spectrum Disorder (ASD) is a developmental dysfunction that affects a person’s speech, cognitive abilities and behaviour. Autism is a blanket term for a broad range of complex conditions that are characterised by challenges with social skills, communication and interpersonal relationships. As the name suggests, autism is a spectrum and can affect individuals differently and be more or less severe and noticeable from case to case. 

Autism frequently co-occurs with a long list of other conditions, and is closely linked with epilepsy. Studies have shown that autistic people are more likely to develop epilepsy and people with epilepsy are more likely to be autistic than those who are considered neurotypical.

A 2013 study that included nearly 6,000 children with autism found that 12.5% had epilepsy, however other studies with similar numbers have ranged from 2% up to as much as 46%. 

Can epilepsy cause autism? 

Although there is much evidence to suggest a connection between epilepsy and autism, there is none to suggest that the relationship is cause and effect. It’s not yet clear whether epilepsy and autism contribute to each other or that either is a consequence of the other. 

Another factor to consider is that autism is not known to be associated with a specific type of epilepsy, with autistic people reporting all types of seizures and syndromes. Epilepsy onset most commonly happens in early childhood and during adolescence, but as many as 20% of people with autism experience their first seizure in adulthood. 

The role of Intellectual Disability (ID)

Several studies have been conducted into the link between autism and epilepsy and have found that the presence of intellectual disability (ID) contributes to the risk factor for children with autism to develop epilepsy. Autistic children without an ID carry a risk of 8%, but this increases to 20% for those with an ID and the risk can be as high as 40%. 

In fact, of all of the children with autism, those who have an IQ above 70 are only at 4% risk of developing epilepsy. It’s not yet clear why ID plays a role in the risk of developing epilepsy, but the evidence that there is a link is strong and agreed upon by several studies. 

Genetic factors 

There have been multiple studies that have suggested that epilepsy and autism share a common genetic origin, which may explain the link. A 2013 study was conducted into the link and found that there were commonalities between the genes linked to autism and epilepsy.

Researchers have linked several common genes to epilepsy and autism, including SCN2A and HNRNPU. It’s these common biological mechanisms that are believed to be the reason behind the connection between autism and epilepsy.  

Support for a person with autism and epilepsy

Ensuring adequate support for a person with both autism and epilepsy means taking into accounts the needs for both, whilst ensuring support and treatment for each individually. In many ways, supporting someone with autism and epilepsy is very much the same as someone who is neurotypical. 

However, where the difference will often arise is the challenge of communication. A person with autism may struggle to communicate how they’re feeling or when they need help. A person will often know when a seizure might be imminent or whether there’s a potential trigger in the environment, but could be unable to communicate that and get assistance.