Seven children, ages 3 to 8 years, presenting with autism or autistic regression and seizures had occipital spikes, characteristic of benign epilepsies, in a report from New York University Medical Center. Clinical findings included borderline or mental retardation, delayed or regressing language development, autistic and hyperactive behavior, and chronic motor tics. Seizures consisted of absence or myoclonic patterns, usually resistant to antiepileptic drugs. A causal relation between occipital spikes and cognitive and language regression was suggested, reflecting extension of epileptiform activity into temporal and posterior-parietal areas. [1]

COMMENT. The relation between EEG epileptiform abnormalities and cognitive, language, and behavioral disorders is controversial. The correlation between the seizure, behavioral, and language disorders in children with Landau-Kleffner syndrome and autistic epileptiform regression is debatable. A temporal relation between treatment with antiepileptic drugs and clinical improvement is sometimes supportive, but responses are often unsustained. This report is the first to relate occipital spikes or spike-wave epileptiform EEGs to cognitive, language, and autistic regression. See Progress in Pediatric Neurology II, 1994;pp220-226.