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Autism: electroencephalogram abnormalities and clinical improvement with valproic acid.

Autism is a severe disorder of social and communicative development. Although there are a number of biomedical causes of autistic symptoms, 1 a cause has not been identified for the majority of children with this condition. There is a much higher prevalence of epilepsy and electroencephalographic (EEG) abnormalities in autistic children as compared with controls. 2,3 However, it is not clear whether autistic children with epileptiform abnormalities on EEGs (spikes and/or sharp waves) who have never had seizures would benefit from anticonvulsants. In a comprehensive review of autism, Minshew et al 4 mentioned nonconvulsive seizures as a possible association with autism but recommended further testing and anticonvulsants only in those children with clinical indications of possible epileptic phenomena. More significantly, in a recent review of autism, Rapin 5 wrote: "There is little evidence to suggest that seizure-free children with rare spikes or other paroxysmal EEG discharges will benefit from anticonvulsants."