难治性癫癎的相关因素分析

目的探讨儿童难治性癫癎(IE)的临床相关因素。方法采用回顾性分析的方法对38例IE患儿(IE组)与40例药物治疗有效的癫癎患儿(对照组)的临床资料(包括起病年龄、发作频率、发作形式、脑电图表现、头颅影像学改变、智能情况、家族史、服药依从性,对首次用药治疗的反应情况等)进行对比分析。结果 IE组1岁前的发病率、发作频率、出现多种发作形式和伴智能障碍率、头颅影像学及脑电图异常率均较对照组增高,差异均有统计学意义(Pa<0.05);IE组首次应用抗癫癎药物治疗反应不良、联合多种药物控制发作及药物治疗依从性差的概率较对照组亦增高,差异均有统计学意义(Pa<0.05)。结论儿童IE与发病年龄小、发作频繁、症状性癫癎或癫癎综合征、多种发作形式共存、伴智能障碍、头颅影像学及脑电图异常改变率高、首次应用抗癫癎药物治疗的反应差、联合多种药物治疗、药物治疗的依从性差等诸多因素有关。     

皖南山区家族性全面性强直-阵挛性发作患儿智商及影响因素

目的 分析家族性全面性强直-阵挛性发作(GTCS)患儿和他们同胞的智商(IQ),探讨影响癫(癎)患儿IQ的相关因素.方法 选择皖南山区20个癫(癎)家系中的9～16岁的GTCS患儿28例作为试验组,随机抽选28例与患儿年龄差距最小同胞儿童为对照1组,30例同村的年龄、性别匹配相近的健康儿童为对照2组,比较3组儿童的IQ水平;并记录癫(癎)发病的相关资料和影响儿童IQ的因素.结果 1.试验组32%儿童IQ在平均水平,21%高于平均水平;与对照1组及对照2组比较均有显著差异(Pa <0.01);2.试验组儿童的总智商较对照1组、对照2组均显著降低(Pa <0.001),除了填图与图片排列外,试验组所有其他分测验得分和2个对照组之间均有显著性差异;3.2个对照组之间的IQ水平及各分测验得分无显著性差异;4.癫(癎)患儿IQ与父亲受教育程度、癫(癎)发病年龄、癫(癎)发作病程、癫(癎)发作频率、癫(癎)持续状态显著相关(r=0.453,0.506,-0.533,-0.708,-0.732 Pa <0.05);5.多元线性逐步回归分析,父亲受教育程度与癫(癎)发作病程是影响癫(癎)患儿IQ的主要因素.结论 家族性GTCS患儿的IQ及各分测验得分明显低于健康儿童;其同胞的IQ水平与健康儿童无统计学差异;癫(癎)发作病程、父亲受教育程度是影响患儿IQ最重要的癫(癎)因素,其他依次为:癫(癎)持续状念、起病年龄、癫(癎)发作次数、癫(癎)发作频率.     

儿童症状性癫(癎)308例病因分析

目的 探讨儿童症状性癫(癎)常见病因及不同年龄段病因构成特点.方法 以2004年1月至2007年1月在湖南省儿童医院神经内科住院的308例症状性癫(癎)患儿为病例组,同期住院的202例非(癎)性发作患儿为对照组,采用前瞻性调查方法并通过自制问卷调查表对两组患儿的家长进行调查;对所有病例均进行了详细体格及神经系统检查;所有患儿均查脑电图、头颅CT和(或)头颅MRI.采用单因素和多因素分析;对各组病因构成比进行?检验.结果 (1)单因素分析显示围生期损伤、先天性脑发育异常、颅内感染、热性惊厥、神经皮肤综合征、颅脑外伤等与儿童症状性癫(癎)相关(P<0.05).将其引入多因素Logistic回归模型,显示儿童症状性癫(癎)与围生期损伤、先天性脑发育异常、颅内感染、热性惊厥有显著相关.(2)相似文献   

癫癎儿童心理状态及影响因素的调查研究

目的评估癫癎儿童的心理状态,分析影响癫癎儿童心理状态的可能因素。方法采用儿少心理健康量表(MHS-CA)对113例癫癎儿童和114例正常儿童进行心理状态评定及比较。癫癎组儿童填写患儿一般情况和癫癎病情及治疗情况调查表。正常对照组儿童填写儿童一般情况调查表。分析影响癫癎儿童心理状态的可能因素。结果癫癎儿童在认知、思维、情绪、意志行为、个性特征上的心理健康状态均低于对照组儿童,差异有统计学意义(P0.05)。多因素logistic回归分析显示家庭教育方式、家庭关系、癫癎发作频率、癫癎发作持续时间、近6个月EEG癎样放电、抗癫癎药物使用种数为影响癫癎儿童心理状态的危险因素。结论癫癎儿童较正常儿童存在更广泛的心理健康问题。家庭生活环境差、癫癎控制不佳及多种抗癫癎药物应用是影响癫癎儿童心理状态的危险因素;改善家庭生活环境,尽量控制癫癎发作及使用单药治疗有助于改善癫癎患儿心理状态。     

癫(癎)患儿预后与相关因素的远期随访研究

目的 分析影响癫(癎)患儿预后的相关因素,为癫(癎)的诊治和预后评估提供依据.方法 回顾性分析2003年1-12月在北京大学第一医院儿科门诊就诊的290例癫(癎)患儿的临床资料,随访患儿发作、用药、智力及精神运动发育等情况,以至少1年无发作为疗效控制指标.结果 ①经正规抗癫(癎)药物治疗,57.9%患儿发作控制满意,多数可以正常学习或生活;(②各型癫(癎)均有控制发作的可能,不同发作类型癫(癎)的控制率不同;③起病年龄越早,特别是1岁内起病者发作控制较差;④原发性癫(癎)控制率明显高于症状性或隐源性癫(癎),症状性癫(癎)预后最差;⑤大部份病例经单药治疗可以控制发作,2种药物治疗未控制者,再添加药物进行治疗,控制率无明显提高.结论 儿童癫痫的预后大多良好,有下列情况者预后差:①起病年龄小,尤其是1岁者;②同时有多种发作形式;③症状性癫(癎).     

奥卡西平治疗儿童癫(癎)的临床随访研究

目的 探讨奥卡西平治疗儿童癫(癎)部分性发作及难治性癫(癎)的临床疗效和安全性.方法 2005-2006年上海新华医院小儿神经科收治癫(癎)患者52例,其中新诊断和未经治疗癫(癎)部分性发作患者37例为单药治疗组;15例为既往经2种以上抗癫(癎)药正规治疗,发作仍未控制者为添加治疗组.起始剂量5～10 mg/(kg·d),每日2次口服,每5～7 d,增加5～10 mg/(kg·d),目标剂量20～40 mg/(kg·d).观察期为6个月至2年,进行自身对照开放性研究,观察其疗效、安全性及依从性,分析剂量与不同年龄及疗效的关系.结果 单药治疗组有效率为(控制+显效+有效)89.19%,控制率为67,57%,退出率为2.70%;难治组有效率为46.67%,控制率为13.33%,退出率为26.67%.共5例退出,1例因皮疹退出,4例因发作未能控制而退出.小于4岁患儿的平均剂量较年长儿显著增高(P＜0.05).发作减少50%以上的病例的平均剂量较发作减少50%以下者显著增高(P＜0.05).21.15%的病例发生不良反应,包括困倦、头晕、乏力、皮疹等,无低钠血症发生.结论 奥卡西平治疗儿童部分性癫(癎)疗效显著,对难治性癫(癎)的也有一定的疗效,临床应用依从性良好,不良反应较少,安全性好.     

儿童癫痫影像学检查的意义

目的为阐述影像学检查对病因诊断和癫癎分类意义,并就癫癎患儿影像学检查提出合理建议.方法将318例初次被诊断癫癎并接受神经影像学检查(包括CT和MRI)患儿,根据影像学检查结果,分为正常组和异常组.结果影像学异常表现多样;影像学检查结果阳性组平均发病年龄小,肌阵挛性发作多,且多伴发育迟缓、脑性瘫痪,有显著性差异(P＜0.05);所有失神癫癎患儿影像学检查均为阴性.结论影像学检查在癫癎病因方面有重要临床意义,但对儿童失神癫癎患儿可不必行影像学检查.     

良性癫(癎)伴中央颞区棘波与其他类型癫(癎)偏头痛发生率的比较

目的 探讨良性癫(癎)伴中央颞区棘波(BECT)与其他类型癫(癎)和偏头痛是否有共同的发病基础.方法 2003年6月至2006年6月对山东大学齐鲁医院收治的BECT患儿采用配对队列研究,每l例BECT患儿(共53例入组)根据年龄和性别匹配1例隐源性或症状性部分发作性癫(癎)患儿和l例无癫(癎)发作患儿.向入组队列的患儿父母或直接监护人问卷或电话访谈,收集有关患儿家庭情况、偏头痛或偏头痛等位症信息.根据国际头痛协会(HIS-R)制定的修订版头痛分类标准,比较各队列组癫(癎)发作情况和偏头痛发生率之间的差异.结果 BECT组简单部分性发作比例较隐源性或症状性癫(癎)组高(P<0.01);在隐源性或症状性癫(癎)组中,15例(28.3%)为癫(癎)病灶在前额,12例(22.6%)癫(癎)病灶在颞叶,3例(5.7%)病灶在前颞,3例(5.7%)病灶在枕叶,1例(1.9%)病灶在顶叶,8例(15.1%)病灶在中央,11例(20.8%)为多灶性.5例(9.4%)曾行过癫(癎)外科手术.两癫(癎)发作组中偏头痛发生率差异没有统计学意义.但隐源性或症状性组癫(癎)发作后头痛较BECT组高(P<0.05).与无癫(癎)发作组相比,肯定型和可能型偏头痛发生率较高(P=0.05).隐源性或症状性癫(癎)中有8例头痛只发生在癫(癎)作后,而BECT组中无1例是这种情况.有先兆型偏头痛的在癫(癎)发作组中差异没有统计学意义,但和无癫(癎)相比,BECT组良性发作性眩晕发生率较高(P<0.05),运动性呕吐发生率也较高(P<0.01).其直系亲属中母亲91%而父亲53%有头痛病史.除了隐源性或症状性组中儿童母亲有先兆无偏头痛发生率较其他组高外,其余差异均无明显统计学意义.结论 癫(癎)和偏头痛发病机制之间可能存在共同的易患基础,癫(癎)发作可能加重偏头痛的易患倾向.     

癫(癎)患儿血清S-100β、胶质纤维酸性蛋白变化的意义

目的 探讨癫(癎)发作患儿及治疗后血清S-100β、胶质纤维酸性蛋白(GFAP)的变化.方法 采用双抗体夹心酶联免疫吸附法对41例癫(癎)患儿在癫(癎)发作24 h内、用药4、12周分别进行定量测定其血清S-100β、GFAP蛋白水平,并与30例健康儿童进行比较.采用SPSS 11.0软件进行分析.结果 发作后24 h:癫(癎)组患儿血清S-100β、GFAP蛋白水平均显著高于对照组(Pa＜0.01);婴儿痉挛症组血清S-100β、GFAP蛋白水平明显高于其他各组(Pa＜0.01);局限性发作与全面性发作组比较,2组S-100β、GFAP蛋白水平无显著性差异(P＞0.05).用药后4周:癫(癎)组血清S-100β、GFAP水平较前明显下降,但仍高于健康对照组(P＜0.01).用药后12周:根据癫(癎)控制标准,控制23例,显效12例,有效4例,无效2例;各组S-100β、GFAP蛋白水平明显下降,无效组与其他各组比较,S-100β、GFAP蛋白水平仍高(P＜0.05);其余各组比较无显著差异.癫(癎)患儿血清S-100β、GFAP蛋白水平经直线相关分析呈高度正相关(r=0.54 P＜0.01).结论 血清S-100β、GFAP水平在发作后癫(癎)患儿明显升高,临床控制效果与S-100β、GFAP蛋白水平高低、下降速度有关,二者可作为早期预测脑损伤、损伤程度并判断预后的指标之一.     

小儿结节性硬化症合并癫癎的随访研究

目的：调查结节性硬化症（TSC）合并癫癎的治疗转归及癫癎反复发作的高危因素。方法：回顾性分析我院66例TSC患儿的资料。结果：66例TSC患儿中,随访47例,随访时间为7个月至9.3年,平均4.5±2.6年。患儿现在年龄7.7±4.1岁,癫癎发作类型：40%有婴儿痉挛症,51%有强直性发作,32%有部分性发作,强直-阵挛性发作占6%,多灶性发作、失张力发作、不典型失神发作、抑制性运动发作各占2%。目前使用抗癫癎药1.9±0.86种,中位数1种。26%仍然癫癎发作,70%无发作,4%死亡。手术治疗3例,均在继续用药,随访1.5年以上,无发作。应用非条件logistic回归方法分析,发现起病年龄（RR=1.8, 95% CI 1.0～3.2, P=0.050）、抗癫癎药的种类(RR=4.8, 95% CI 1.2～18.6, P=0.024)、强直发作(RR=0.003, 95% CI 0.0～0.2, P=0.04)、性别(RR=0.016, 95% CI 0.0～0.5, P=0.017）是癫癎反复发作的高危因素。30例7岁以上儿童57%例可以上普通学校, 10%上特殊学校; 33%因为智力、言语发育落后不能上学。结论：对TSC合并癫癎进行抗癫癎治疗可以达到大部分无发作。癫癎发作起病年龄早、强直发作、需要多种抗癫癎药是癫癎反复发作的高危因素。［中国当代儿科杂志,2009,11（12）：996-998］     

儿童癫癎的诊断和治疗

目的研究癫癎诊断和治疗的现状。方法采用回顾性分析方法,对5年间450例门诊和住院的癫癎患儿资料进行发作类型与年龄的关系、脑电图及药物的疗效分析。结果450例中全面性发作63.1%(284例),其中大发作33.3%(150例);局限性发作16.7%(75例);其他类型发作20.2%(91例)。本组68.2%为6岁以下儿童,其中<3岁占73%。1岁以内发作类型最常见为婴儿痉挛(WS),占该年龄组的41.1%(46/112例)。失神发作见于学龄期儿童,占本组病例的2.4%,Lennox-Gastaut综合征在9岁前各年龄组均可发生,热性惊厥转变为大发作见于学龄期儿童。癫癎发作的诱因主要为发热,有家族史占各种诱因的4.7%。癫癎的病程最长13年。脑电图(EEG)异常率达74.9%,其中普通EEG示癎样放电为50.5%,加做video-EEG或24h动态EEG后阳性率达62.8%。65.7%无影像学异常改变。120例(26.7%)诊断后未治疗或服药后未复诊。330例中单药治疗组总疗效76.5%,联合用药组为55.6%,两者之间疗效存在显著差异(P<0.05),而单药治疗组与WS组疗效比较无显著性差异(P>0.05)。结论癫癎治疗以单药治疗为主,但WS联合用药效果较佳。癫癎治疗滥用药现象较严重,有待规范化治疗。     

Prognostic value of hyperkinetic syndrome in children with epilepsy

In a retrospective study the data of 43 children suffering from epilepsy were analysed. The first epileptic seizure was observed in all patients before the age of 6 years. The relationship between behavioral disturbances with hyperactivity, developmental respectively intellectual test scores, and efficiency of antileptic drug therapy have been investigated. Psychological testings were performed two times, at first after the start of drug therapy, and a second time after a period of 1 year 11 months in average. There were behavioral disturbances with hyperactivity in 20 patients. The epileptic seizures were intractable in 26 patients. The developmental respectively intellectual test scores have decreased to values below 85 in 7 patients with and 3 patients without hyperactivity. There was a decline by more than 10 points of the IQ score between first and second psychological testings in 16 patients with and 4 patients without hyperactivity, respectively in 17 patients with intractable seizures, but in one child only with prompt cessation of epileptic seizures. An increasing retardation of mental development was seen in children with hyperactivity at the start of seizures, in children with intractable seizures, but especially in patients with a combination of intractable seizures and hyperactivity.     

Parental perception, worries and needs in children with epilepsy

Despite advancement in medical care, prejudice and misunderstanding of epilepsy still exist. In this study, we investigate the problems faced by epileptic children, at home and in school, and make suggestions for improvement. Questionnaires were randomly distributed to parents of epileptic children attending normal and special classes (groups A and B, respectively). Return of questionnaires was anonymous. Ninety-one percent responded. Of the responders, 56 children were in Group A and 30 in Group B. Chronic and intractable epilepsy was more frequently observed in Group B than in Group A patients (47% vs 14%, p < 0.05). Main family concerns were seizures, school performance and side effects of medication. Half of the parents complained that their children were more restless and short-tempered. Only 43% of parents were aware that seizures were caused by abnormal brain discharges. Twenty percent thought swimming should be prohibited even if seizures could be controlled. Schools were informed of the disease by 84% of the families. Only 29% of parents knew the name and dose of the current medication. Information was considered adequate in 27% of patients. Drug compliance was better in epileptic children with associated handicaps than in those without handicaps. Half of the parents requested more information about epilepsy and closer communication between teachers and physicians. CONCLUSIONS: To establish comprehensive care that satisfies the needs of epileptic children and their families, further training of medical specialists in epilepsy and enhancement of networks among relevant organizations are needed.     

儿童额叶癫(癎)的临床与脑电图特征

目的 总结儿童额叶癫癇(FLE)的临床表现、脑电图(EEG)特征和预后.方法 对28例FEE患儿的临床资料进行回顾性分析.结果 起病年龄21个月～17岁,癫癇发作表现:躯体运动性自动症20例,偏转性强直18例,姿势性强直19例,植物神经症状10例,局部阵挛11例,发声9例,额叶失神3例,简单自动症3例,感觉异常1例,发笑发作1例.头颅影像学异常13例,长时间视频脑电图(V-EEG)检查78.6%(22/28例)记录到疴样放电,67.9%(19/28例)记录到临床发作.26例额叶癫癇随访1～6年,抗癫癇药物治疗效果良好15例.结论 额叶癫癇是一组具有特征性的癫癇综合征,V-EEG是临床无创伤性诊断额叶癫癇最佳方法,口服抗癫癇药物疗效良好.     

儿童偏头痛与癫癎相关性的研究

目的　探讨儿童偏头痛与癫的相关性及鉴别诊断。方法　对 32例偏头痛患儿 (其中 9例并临床癫发作 )进行脑电图及临床分析。结果　 32例中脑电图异常 1 8例 ,其中 1 4例为偏头痛 ,异常率为43 .75 % ,4例枕叶癫。 3例普通型头痛伴癫发作 ,脑电图 3次复查正常 ,2例复杂型偏头痛伴临床癫发作 ,脑电图均表现异常。结论　儿童偏头痛常常表现脑电图非特异性异常 ,甚至样放电 ,但以脑电图异常不能代替临床诊断。头痛性癫的诊断必须结合临床表现和脑电图检查结果综合判定 ,并与偏头痛进行鉴别。某些偏头痛可以伴癫发作 ,两者交叉重叠 ,极易混淆。对头痛性癫的诊断应慎重     

视频脑电图在睡眠相关发作性疾病中的诊断价值

目的探讨视频脑电图在睡眠相关发作性疾病的诊断与鉴别诊断中的应用价值。方法收集2005年1月～2006年6月在我院儿科病房和门诊就诊的具有与睡眠相关发作性症状患儿65例。其中拟诊癫痫35例,非性发作性疾病30例。全部行常规脑电图（EEG）和视频脑电图（VEEG）检查。结果拟诊癫痫35例,性波阳性率VEEG为62.86%（22/35）,EEG为17.14%（6/35）,有显著性差异（χ^2=15.23P〈0.01）;经EEG监测,结合其临床表现,确诊癫痫27例中,额叶癫痫2例,颞叶癫痫1例,儿童良性癫痫伴中央中颞区棘波7例;VEEG检查其中样放电22例（81.48%）,睡眠期18例（81.82%）,清醒期11例（50%）,睡眠相关性癫痫睡眠期异常放电率高于清醒期（χ^2=4.96P〈0.05）;共监测到发作22例,其中非癫痫性发作15例（睡眠肌阵挛10例、睡眠障碍3例、阵发性肌张力不全,生长痛各1例）。结论VEEG是鉴别发作性质及类型的最有效检查方法,也是鉴别癫痫与非癫痫性发作的有效方法。     

EEG abnormalities preceding the epilepsy onset in tuberous sclerosis complex patients – A prospective study of 5 patients

Tuberous sclerosis complex (TSC) is a multisystem, autosomal dominant disorder characterized by multiple hamartomas development. Epilepsy is the most common symptom appearing in 80–90% of the patients mainly in the first year of life. A prompt and early seizure control is crucial and can prevent development of an epileptic encephalopathy and secondary mental retardation. Therefore the very early identification of seizures seems to be of a great importance. We present the cases of 5 patients diagnosed with TSC prenatally or perinatally and regularly monitored (at 4–6 weeks intervals) with EEG before the epilepsy onset. The patients' age at baseline varied from 9 days to 9 weeks. In all of the patients epileptiform discharges preceded the epilepsy onset. The time interval between abnormality detection on EEG and the epilepsy onset varied from 1 to 8 days. The patient's age at the epilepsy onset ranged from the 17th day to the 5th month of life. In one patient the EEG was abnormal from the beginning and in this patient the epileptic seizures started from the neonatal period. In the rest of the patients (4/5) the EEG remained normal throughout the first months of life. In all of the children epilepsy started with focal motor seizures. Our study is the first prospective one showing the results of the EEG monitoring in TSC patients and the natural evolution of the EEG patterns in patients with the seizures types other than infantile spasms.     

孤独症谱系障碍儿童的血清胰岛素样生长因子-1和胰岛素样生长因子结合蛋白-3水平研究北大核心CSCD

目的探讨孤独症谱系障碍(autism spectrum disorder,ASD)儿童的血清胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)和胰岛素样生长因子结合蛋白-3(insulin-like growth factor binding protein-3,IGFBP-3)水平及与孤独症核心症状之间的关系。方法前瞻性选取重庆市妇幼保健院门诊招募的150名2~7岁ASD儿童和165名年龄、性别相匹配的正常健康儿童为研究对象,采用孤独症行为量表和孤独症评定量表评估ASD儿童核心症状,采用化学发光法检测两组儿童血清IGF-1和IGFBP-3水平。结果ASD组儿童血清IGF-1水平低于对照组儿童(P<0.05)。重度ASD儿童血清IGF-1和IGFBP-3水平低于轻-中度ASD儿童(P<0.001),2~3岁ASD儿童血清IGF-1水平低于对照组儿童(P<0.05)。两组男童IGF-1水平均低于女童(P<0.05)。血清IGF-1、IGFBP-3水平与儿童孤独症评定量表总分呈负相关(分别r=-0.32、-0.40,均P<0.001)。结论儿童早期血清IGF-1降低可能与ASD疾病发展相关,血清IGF-1和IGFBP-3水平与ASD儿童核心症状具有一定关联。     

Epilepsy in Hydrocephalic Children

ABSTRACT. Epilepsy and epileptogenic activity in EEGs were studied in 168 shunt treated hydrocephalic (HC) children, the mean age at first operation 1.62 years (SD 1.87). 80 patients (47.6%) suffered from epileptic seizures during the follow-up period (mean 8.9 years). The epileptic seizures appeared before the initial shunting, and after the first shunt inplantation in 43 (25.6%). There was no correlation between epilepsy and the aetiology of HC, number of shunt revisions, or shunt infections. Sixteen patients suffered from seizures during the neonatal period. Generalized spike and wave activity (SWA) was seen in EEG in eight out of these, and only one was seizure-free at the end of the follow-up period. All eight patients with epileptic seizures during the neonatal period without generalized SWA in EEG were seizure-free, however. SWA was seen in the first EEG prior to shunting in 75/168 patients (44.6%). All those patients who did not receive prophylactic medication, developed epileptic seizures, whereas 68.1% of those who received prophylactic anticonvulsive medication remained free of seizures. Partial epilepsy after shunting manifested itself in 15 patients, but this did not correlate with the side of the sunt or with the side of the SWA in the EEG. Slit ventricles (SLV) developed in 75 patients during the follow-up period, while the ventricles remained normal or dilated in 66 cases (27 patients had no CT follow-up). Epilepsy manifested itself in 8 out of these 141 patients (2 SLV, 6 non-SLV) during the first postoperative year, and in 29 patients in the SLV group and one in the non-SLV group at some time after the first postoperative year.     

Pragmatic difficulties in children with autism associated with childhood epilepsy

PURPOSE: The intention of this study was to examine specific pragmatic functions in 35 children, aged 6-11 years, with a history of epilepsy (mean length of duration 6.5 years), who demonstrated autistic features, ASD or autistic regression. METHOD: The children's ability to recognize and convey communicative intentions, conversational engagement and paralinguistic features were investigated using the Pragmatics Profile of Everyday Communication Skills in Children using semi-structured key-worker interviews. The association between weak or abnormal prosody and epileptic focus was also examined. RESULTS: Findings demonstrate a strong association between early onset epilepsy with autism or autistic regression and additional pragmatic impairment. A number of children exhibited weak or abnormal prosody in association with temporal lobe EEG abnormalities, particularly in the non-dominant hemisphere. Consideration is given to recent studies of the converse--the presence of a reducing prevalence of epilepsy in the autism population and acknowledgment of implications for learning within the autistic population.