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Autism

Seizure Outcomes in Autism Spectrum Disorder Improve with Surgery

Strategic Insights

— 1 min read

A new study published in Epilepsia suggests that surgical interventions can be a viable treatment option for individuals with autism spectrum disorder (ASD) and epilepsy, with significant improvements in seizure frequency and quality of life. The systematic review and meta-analysis of 46 studies involving 325 patients with ASD and epilepsy found that resective surgery and neuromodulation led to improved seizure outcomes, with 54% of patients experiencing seizure freedom after resections and 80% seizure reduction in 33.5% of patients undergoing neuromodulation.

Key Takeaways:

  • The study found that resective surgery resulted in seizure freedom in 54% of patients, while neuromodulation led to 80% seizure reduction in 33.5% of patients.
  • The incidence proportion of seizure freedom after surgery was higher in patients with MRI abnormalities (55%, 95% CI: .34-.75) compared to those without MRI abnormalities (19%, 95% CI: .01-.81).
  • Temporal resection yielded a higher incidence proportion of seizure freedom (80%, 95% CI: .50-.94) compared to extratemporal resection (66%, 95% CI: .48-.80).
  • Improvement in neuropsychiatric or quality of life outcomes was reported in the majority of patients after surgery.
  • The study's findings provide the most comprehensive review to date of epilepsy surgery in ASD.

Statistics:

  • 325 patients with ASD and epilepsy were included in the study.
  • 46 studies were queried from inception to November 2024.
  • 137 patients underwent resective surgery.
  • 167 patients underwent neuromodulation (138 vagus nerve stimulation, 27 responsive neurostimulation, 2 deep brain stimulation).
  • 21 patients underwent other palliative procedures (17 corpus callosotomy and 4 laser interstitial thermal therapy).
  • 54% of patients experienced seizure freedom after resections.
  • 80% seizure reduction in 33.5% of patients undergoing neuromodulation.
  • 55% (95% CI: .34-.75) incidence proportion of seizure freedom after surgery in patients with MRI abnormalities.
  • 19% (95% CI: .01-.81) incidence proportion of seizure freedom after surgery in patients without MRI abnormalities.
  • 80% (95% CI: .50-.94) incidence proportion of seizure freedom after temporal resection.
  • 66% (95% CI: .48-.80) incidence proportion of seizure freedom after extratemporal resection.

Sources:

  • Epilepsia (Wiley)
  • Mental Health Weekly Digest (NewsRx)
  • Icahn School of Medicine at Mount Sinai (New York, NY, USA)
  • Epilepsia (onlinelibrary.wiley.com/journal/10.1111/(ISSN)1528-1167)
  • Wiley (www.wiley.com/)
  • Jonathan Goldstein (Icahn School of Medicine at Mount Sinai)
  • Varun R. Subramaniam (Icahn School of Medicine at Mount Sinai)
  • Ali Rafati (Icahn School of Medicine at Mount Sinai)
  • Paul Gorka (Icahn School of Medicine at Mount Sinai)
  • Churl-Su Kwon (Icahn School of Medicine at Mount Sinai)

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