Febrile Seizures and Epilepsy: Association with Autism and other Neurodevelopmental Disorders

Publication date: Available online 8 June 2017
Source:Pediatric Neurology
Author(s): Christopher Gillberg, Sebastian Lundström, Elisabeth Fernell, Gill Nilsson, Brian Neville
BackgroundThere is a recently well-documented association between childhood epilepsy and ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) including Autism Spectrum Disorder (ASD) but the relationship between febrile seizures (FS) and ESSENCE is less clear.MethodsThe Child and Adolescent Twin Study in Sweden (CATSS) is an ongoing population–based study targeting twins born in Sweden since July 1, 1992. Parents of 27,092 twins were interviewed using a validated DSM-IV based interview for ESSENCE, in connection with the twins' 9^th or 12^th birthday. Diagnoses of FS (n=492) and epilepsy (n=282) were based both on data from the Swedish National Patient Register (NPR). Prevalence of ESSENCE in FS and epilepsy were compared with prevalence in the twin population without seizures. The association between FS and ESSENCE was considered before and after adjustment for epilepsy. Age of diagnosis of FS/epilepsy was considered as a possible correlate of ESSENCE in FS and epilepsy.ResultsThe rate of ESSENCE in FS and epilepsy was significantly higher than in the total population without seizures (all p<0.001). After adjusting for epilepsy, a significant association between FS and ASD, Developmental Coordination Disorder and Intellectual Disability remained. Earlier age of onset was associated with all ESSENCE except Attention-Deficit/Hyperactivity Disorder (ADHD) in epilepsy but not with ESSENCE in FS.InterpretationIn a nationally representative sample of twins, there was an increased rate of ESSENCE in childhood epilepsy and in FS. FS alone could be seen as a marker for a broader ESSENCE phenotype in some cases.



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