Treatment of Seizures with Brain Dysfunction: Autism model

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Seizure disorder is frequently seen in patients with autism.

Study

Recently an international expert panel led by Dr. Frye from the Arkansas Children’s Hospital Research Institute, Little Rock, AR conducted a systematic review of medical literature on the effectiveness of various therapies for seizure disorder in autism.

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Study concerns

They lamented at “the striking lack of clinical trials performed to support the use of these treatments”.

Study results

They drew the following conclusions from the limited literature available. The grade of evidence for effectiveness in autism with seizures is provided on a scale of A to D.

Most effective drugs for epilepsy in autism in general
Valproate (C)
Lamotrigine (C)
Levetiracetam (C)

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Non-drug treatments (limited evidence)

• Ketogenic (C)
• Modified Atkins diet (C)
• Surgery, mostly multiple subpial transections (C)
• Neurofeedback treatment (C)

Auism associated with mitochondrial disorders and dysfunction (limited evidence)

• L-carnitine
• Multivitamins
• N-acetyl-l-cysteine 

Autism associated with tuberous sclerosis complex

• Vigabatrin (C)
• Abnormal folate in brain (limited evidence)
• Folinic acid (C)

Novel treatments (limited evidence)

• Magnesium with pyridoxine (D)
• Omega-3 fatty acids
• Gluten-free casein-free diet (C)
• Low-frequency repetitive transcranial magnetic simulation

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Novel treatments (supported by basic science)

• Zinc
• L-carnosine

Dr. Minocha’s comments
Overall the literature is limited at best. Patient characteristics of autistic symptoms plus seizures would guide the treatment with medications and non-traditional therapies as a valuable adjunct. More studies are sorely needed to identify effective treatment of seizures in patients with autism.