Richard E. Frye1*, Daniel Rossignol2, Manuel F. Casanova3, Gregory L. Brown4, Victoria Martin4, Stephen Edelson5, Robert Coben6, Jeffrey Lewine7, John C. Slattery1, Chrystal Lau1, Paul Hardy8, S. Hossein Fatemi9, Timothy D. Folsom9, Derrick MacFabe10 and James B. Adams11 1Arkansas Children’s Hospital Research Institute, Little Rock, AR, USA 2Rossignol Medical Center, Irvine, CA, USA 3University of Louisville, Louisville, KY, USA 4Autism Recovery and Comprehensive Health Medical Center, Franklin, WI, USA 5Autism Research Institute, San Diego, CA, USA 6New York University Brain Research Laboratory, New York, NY, USA 7MIND Research Network, University of New Mexico, Albuquerque, NM, USA 8Hardy Healthcare Associates, Hingham, MA, USA 9University of Minnesota Medical School, Minneapolis, MN, USA 10University of Western Ontario, London, ON, Canada 11Arizona State University, Tempe, AZ, USA
Despite the fact that seizures are commonly associated with autism spectrum disorder (ASD), the effectiveness of treatments for seizures has not been well studied in individuals with ASD. This manuscript reviews both traditional and novel treatments for seizures associated with ASD. Studies were selected by systematically searching major electronic databases and by a panel of experts that treat ASD individuals. Only a few anti-epileptic drugs (AEDs) have undergone carefully controlled trials in ASD, but these trials examined outcomes other than seizures. Several lines of evidence point to valproate, lamotrigine, and levetiracetam as the most effective and tolerable AEDs for individuals with ASD. Limited evidence supports the use of traditional non-AED treatments, such as the ketogenic and modified Atkins diet, multiple subpial transections, immunomodulation, and neurofeedback treatments.
Although specific treatments may be more appropriate for specific genetic and metabolic syndromes associated with ASD and seizures, there are few studies which have documented the effectiveness of treatments for seizures for specific syndromes. Limited evidence supports l-carnitine, multivitamins, and N-acetyl-l-cysteine in mitochondrial disease and dysfunction, folinic acid in cerebral folate abnormalities and early treatment with vigabatrin in tuberous sclerosis complex.
Finally, there is limited evidence for a number of novel treatments, particularly magnesium with pyridoxine, omega-3 fatty acids, the gluten-free casein-free diet, and low-frequency repetitive transcranial magnetic simulation. Zinc and l-carnosine are potential novel treatments supported by basic research but not clinical studies. This review demonstrates the wide variety of treatments used to treat seizures in individuals with ASD as well as the striking lack of clinical trials performed to support the use of these treatments. Additional studies concerning these treatments for controlling seizures in individuals with ASD are warranted.
Putting an End to Autism by Fighting Brain Immunity Storms™
The science category is sponsored by AutismFreeBrain, Inc. was created to fund innovative research to develop a cure for Autism Spectrum Disorders (ASD). Our studies have identified inflammatory processes in the brain, we called Brain Immunity Storms, that are much like an allergic reaction, releasing surges of molecules that disrupt areas of the brain responsible for emotion and language.