The relationship of epilepsy and epileptiform EEG abnormalities to language and behavioral regression in children with pervasive developmental disorders or autism was studied in 585 patients at the Miami Children’s Hospital, Florida. Regression had occurred in 30%, and 11% had a history of epilepsy. EEGs were epileptiform in 59% of 66 epileptic, and 8% of 335 nonepileptic children. Regression occurred equally in nonepileptic and epileptic children; and was associated with an epileptiform EEG in 14% of those without epilepsy. Language regression was correlated 1) with an epileptiform EEG in children without epilepsy, and 2) with more severe cognitive dysfunction. 
COMMENT. The occurrence of language regression in children with autism is not closely associated with a history of epilepsy but does show a link with epileptiform EEGs in those without clinical epilepsy. The prevalence of epilepsy in young children with autism is relatively low (11%) but may reach more than 30% in adult life. Sleep EEGs are important to uncover epileptiform discharges in autistic children without epilepsy; language and social skills may improve after treatment with valproic acid. (see Progress in Pediatric Neurology III, PNB Publ, 1997; Ped Neur Briefs March 1994;8:20).