On Purple Day: We Need Awareness of Ties between Epilepsy, Migraine Pain, Autism and Intellectual Disability

The Complex Relationship Between Autism Spectrum Disorders and Epilepsy .... AND Intellectual Disability ... AND Migraine, Pain

Today is Purple Day intended to bring awareness about Epilepsy a condition which can be painful and life ending, creating a drastically shortened life expectancy, 30 years shorter for persons with autism spectrum disorder and epilepsy.  A third major element association with both ASD and Epilepsy is Intellectual Disability and all three of those have significant ties to Migraine Pain:

Chicken or egg? Does autism cause epilepsy or epilepsy cause autism?

• Based on several meta-analysis studies and pooled data review, autism and epilepsy tend to co-occur in about 30% of individuals.
• In children with ASD, intellectual disability (ID) is a major risk factor for developing epilepsy with an estimated risk of 8% for those without ID and as high as 20% in those with ID.4
• Seizures may first begin in adolescence or adulthood.
• Approximately 4-5 % of children with epilepsy will have ASD.5
•  It is becoming clear that ID is common whether we are dealing with children who develop autism first and then go on to develop epilepsy or children with early onset epileptic encephalopathies with autistic features such as tuberous sclerosis complex (TSC). Thus, there is a shared mechanism between autism, epilepsy, and ID.6

Migraine And Epilepsy Are Highly Comorbid.

Individuals with one disorder are at least twice as likely to have the other.1,4–7 Comorbid disease presents challenges in both differential diagnosis and concomitant diagnosis.8 When diseases are comorbid, the principle of diagnostic parsimony does not apply. Individuals with one disorder are more likely, not less likely, to have the other.

In the Epilepsy Family Study, among probands with epilepsy who were classified as having migraine on the basis of their self-reported symptoms, only 44% reported physician-diagnosed migraine.91 In the general population, 29% of men and 40% of women with migraine reported a medical diagnosis.12 The proportion of probands reporting a physician’s diagnosis of migraine was surprisingly low, given that all were already being treated for epilepsy.

Why is the comorbidity of migraine and epilepsy not recognized? Epilepsy may be viewed as a more serious disorder than migraine. As a result, the migrainous symptoms of patients with a diagnosis of epilepsy may have been overlooked or attributed to the seizure disorder.