Neuropsychiatric Symptoms of Epilepsy

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patient and their carers throughout the treatment. At times it may be appropriate to
consider whether an in-patient assessment would be of use in supporting diagnosis
and if indicated initiation of medication.
Despite medication patients can be left with residual psychotic symptoms, and
psychological treatments such as modified CBT, art therapy, and music therapy can
help them manage the impact of their symptoms better. Appropriate support is crucial.
It is also imprtant to consider patients’ adherence to oral medication regimens. If it
appears that medication is helpful but the individual fails to adhere to it, consider treatment
with depot. However, it is important to bear in mind that if adherence to antipsychotics
is in question, then adherence to antiepileptics may well be in question too.
Autism and Epilepsy in People with LD
Prevalence
There appears to be an increased rate of epilepsy in people with autism, with estimates
in children with autism ranging from 5 to 40 %. However, the relationship
between autism and epilepsy is not clearly understood. Epilepsy is associated with
older age, lower cognitive ability, poorer adaptive and language functioning, history
of developmental regression and more severe autistic spectrum disorder symptoms
such that for every one standard deviation increase in IQ, the odds of having epilepsy
decrease by 47 % [ 27 ]. Most studies indicate that prevalence of epilepsy in
autism is around 30 %.
Diagnosis
Core symptoms of autism include impairment in reciprocity of social interaction,
stereotyped repetitive behaviors and clear circumscribed or unusual interests, and
for a diagnosis of autism to be made these symptoms need to have been present
since early childhood. However, it is increasingly being recognized that in people
with more severe learning disability, of various etiologies, a range of autistic traits
may be recognized but that the presence of these do not necessarily confer a definitive
diagnosis of autism.
Management
The management of autism itself is currently limited to various approaches to alleviating
particular symptoms. The approach to managing epilepsy in those with
autism does not differ from the management of epilepsy in the absence of autism.