Research Article
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Otizm Spektrum Bozukluğunda Elektroensefalografinin Rolü: Çocuk Nörolojisi Bakışı

Year 2022, Volume 36, Issue 2, 123 - 133, 30.08.2022
https://doi.org/10.18614/deutip.1174514

Abstract

Amaç: Otizm spektrum bozukluğu’nda (OSB) epileptik dalga formasyonu ve anormal paroksizmal aktivite sık görülen elektroensefalografi (EEG) anormallikleridir. Bu anormalliklerin nöbete dönüşüp dönüşmeyeceği yapılan birçok çalışmaya rağmen henüz bilinmemektedir. Bu çalışmada amacımız OSB tanılı hastalarımızın elektroensefalografik bulgularını değerlendirmektir. Gereç ve Yöntem: Ocak 2015-Aralık 2019 tarihleri arasında bir Çocuk Nöroloji polikliniğinde izlenen OSB’li hastalar retrospektif olarak incelenmiştir. Bulgular: Çalışmaya alınan 49 hastanın yaşlarının ortanca değeri 5’ti (2-17 yaş) ve erkek olgular (n=46, %93,8 erkek; n=3, %6,5 kız) çoğunluktaydı. Hastaların %73’ünde (n=36) mental gerilik mevcuttu. Kırk hasta (%81,6) çocuk psikiyatrisi tarafından atipik otizm tanısı ile izlenmekteydi. Hastalarımızın %34,6’sı (n=17) normal, %65,3’ü (n=32) anormal EEG bulgularına sahipti. Elektroensefalografi anormallikleri zemin aktivitesinde yaşa uygun olmayan organizasyon bozukluğu (n=21; %63,6) ve jeneralize epileptik anormallikti (n=11; %34,3). Zemin aktivitesinde yaşa uygun olmayan organizasyon bozukluğu olan hastaların %33’ünün (n=7) izlemde EEG bulgularının normalleştiği ve nöbet geçirmedikleri görüldü. Epileptik anormalliği olan 8 hastanın 7’sine klinik nöbeti olması nedeniyle anti epileptik tedavi başlandı. Hastalarımızın %85’i normal MRG bulgularına sahipken anormallikler periventriküler lökomalazi, nonspesifik gliotik değişiklikler ve serebellar atrofiden oluşmaktaydı. Tartışma ve Sonuç: Sonuç olarak OSB’li çocuklarda ek nörolojik bulgu ya da özgeçmişlerinde nörolojik bir hastalığı düşündüren bir özellik varlığında beyin MRG; nöbet şüphesi, dil becerisinde gerileme ve eşlik eden mental retardasyon varlığında EEG yapılması gerekmektedir. Ayrıca OSB’de epileptik anormallik sık olsa da yalnızca klinik nöbet varlığında anti epileptik tedavisi verilmesi gerekmektedir.

References

  • 1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA, American Psychiatric Association, 2013. p.50-59.
  • 2. Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J,Warren Z, et al. Prevalence of autism spectrum disorder among children aged 8 years- Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveill Summ 2018;67(6):1–23.
  • 3. O’Reilly C, Lewis J.D, Elsabbagh M. Is functional brain connectivity atypical in autism? A systemic review of EEG and MEG studies. PLoS ONE. 2017;12:e0175870.
  • 4. Olbrich S, van Dinteren R, Arns M. Personalized medicine: Review and perspectives of promising baseline EEG biomarkers in major depressive disorder and attention deficit hyperactivity disorder. Neuropsychobiology. 2015;72:229–240.
  • 5. Pérez Velázquez JL, Galán RF. Information gain in the brain’s resting state: A new perspective on autism. Front. Neuroinform. 2013; 24:7:37.
  • 6. Van DiessenE, Senders J, Jansen FE, Boersma M, Bruining H. Increased power of resting-state gamma oscillations in autism spectrum disorder detected by routine electroencephalography. Eur. Arch. Psychiatry Clin. Neurosci. 2015; 265: 537–0.
  • 7. Ahmadlou M, Adeli H, Adeli A. Fractality and a wavelet-chaos-neural network methodology for EEG-based diagnosis of autistic spectrum disorder. J. Clin. Neurophysiol. 2010, 27, 328–3.
  • 8. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. J. Am. Acad. Child Adolesc. Psychiatry. 2008;47:921–9.
  • 9. Patterson PH. Maternal infection and immune involvement in autism. Trends Mol Med. 2011; 17(7):389-4.
  • 10. Spence SJ, Schneider MT. The role of epilepsy and epileptiform EEGs in autism spectrum disorders. Pediatr. Res. 2009;(65):5996.
  • 11. Strasser L, Downes M, Kung J, Cross JH, De Haan M. Prevalence and risk factors for autism spectrum disorder in epilepsy: A systematic review and meta-analysis. Dev. Med. Child Neurol. 2018;(60):19–9.
  • 12. Kim HL, Donnelly JH, Tournay AE, Book TM, Filipek P. Absence of seizures despite high prevalence of epileptiform EEG abnormalities in children with autism monitored in a tertiary care center. Epilepsia 2006;47(2):394–8.
  • 13. Chez MG, Chang M, Krasne V, Coughlan C, Kominsky M, Schwartz A. Frequency of epileptiform EEG abnormalities in a sequential screening of autistic patients with no known clinical epilepsy from 1996 to 2005. Epilepsy Behav 2006; (1):267–1.
  • 14. Wing L. The autistic spectrum. Lancet 1997;350:1761–6.
  • 15. Messinger DS, Young GS, Webb SJ, Ozonoff S, Bryson SE, Carter A et al. Early sex differences are not autism-specific: A Baby Siblings Research Consortium (BSRC) study. Mol Autism 2015; 6: 32.

Year 2022, Volume 36, Issue 2, 123 - 133, 30.08.2022
https://doi.org/10.18614/deutip.1174514

Abstract

References

  • 1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA, American Psychiatric Association, 2013. p.50-59.
  • 2. Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J,Warren Z, et al. Prevalence of autism spectrum disorder among children aged 8 years- Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveill Summ 2018;67(6):1–23.
  • 3. O’Reilly C, Lewis J.D, Elsabbagh M. Is functional brain connectivity atypical in autism? A systemic review of EEG and MEG studies. PLoS ONE. 2017;12:e0175870.
  • 4. Olbrich S, van Dinteren R, Arns M. Personalized medicine: Review and perspectives of promising baseline EEG biomarkers in major depressive disorder and attention deficit hyperactivity disorder. Neuropsychobiology. 2015;72:229–240.
  • 5. Pérez Velázquez JL, Galán RF. Information gain in the brain’s resting state: A new perspective on autism. Front. Neuroinform. 2013; 24:7:37.
  • 6. Van DiessenE, Senders J, Jansen FE, Boersma M, Bruining H. Increased power of resting-state gamma oscillations in autism spectrum disorder detected by routine electroencephalography. Eur. Arch. Psychiatry Clin. Neurosci. 2015; 265: 537–0.
  • 7. Ahmadlou M, Adeli H, Adeli A. Fractality and a wavelet-chaos-neural network methodology for EEG-based diagnosis of autistic spectrum disorder. J. Clin. Neurophysiol. 2010, 27, 328–3.
  • 8. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. J. Am. Acad. Child Adolesc. Psychiatry. 2008;47:921–9.
  • 9. Patterson PH. Maternal infection and immune involvement in autism. Trends Mol Med. 2011; 17(7):389-4.
  • 10. Spence SJ, Schneider MT. The role of epilepsy and epileptiform EEGs in autism spectrum disorders. Pediatr. Res. 2009;(65):5996.
  • 11. Strasser L, Downes M, Kung J, Cross JH, De Haan M. Prevalence and risk factors for autism spectrum disorder in epilepsy: A systematic review and meta-analysis. Dev. Med. Child Neurol. 2018;(60):19–9.
  • 12. Kim HL, Donnelly JH, Tournay AE, Book TM, Filipek P. Absence of seizures despite high prevalence of epileptiform EEG abnormalities in children with autism monitored in a tertiary care center. Epilepsia 2006;47(2):394–8.
  • 13. Chez MG, Chang M, Krasne V, Coughlan C, Kominsky M, Schwartz A. Frequency of epileptiform EEG abnormalities in a sequential screening of autistic patients with no known clinical epilepsy from 1996 to 2005. Epilepsy Behav 2006; (1):267–1.
  • 14. Wing L. The autistic spectrum. Lancet 1997;350:1761–6.
  • 15. Messinger DS, Young GS, Webb SJ, Ozonoff S, Bryson SE, Carter A et al. Early sex differences are not autism-specific: A Baby Siblings Research Consortium (BSRC) study. Mol Autism 2015; 6: 32.

Details

Primary Language Turkish
Subjects Neurosciences, Neuroimaging
Journal Section Research Articles
Authors

Gamze SARIKAYA UZAN This is me (Primary Author)
DOKUZ EYLÜL ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0002-5028-9995
Türkiye

Publication Date August 30, 2022
Application Date October 14, 2021
Acceptance Date June 17, 2022
Published in Issue Year 2022, Volume 36, Issue 2

Cite

Vancouver Sarıkaya Uzan G. Otizm Spektrum Bozukluğunda Elektroensefalografinin Rolü: Çocuk Nörolojisi Bakışı. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi. 2022; 36(2): 123-133.