Epilepsy in children: why is there an increased risk of autism ?

By Elodie Vaz | Published on May 13, 2026 | 4 min read


Epilepsy and autism spectrum disorder (ASD) are two neurodevelopmental conditions that are frequently associated. Although their coexistence has been known for several years, the underlying mechanisms remain widely debated. A study published on May 6 in the journal Developmental Medicine & Child Neurology provides new insights based on a large population-based cohort. It confirms that children with epilepsy have a significantly increased risk of developing ASD, while also identifying several clinical factors associated with this comorbidity.

Epilepsy and autism: a frequent link

The main objective of the Mayo Clinic researchers was to compare the prevalence of ASD in children with and without epilepsy, and to identify factors that might explain this association. The variables studied included sex, age at autism diagnosis and the presence of intellectual disability. The aim was to better characterize at-risk profiles in order to improve clinical detection.

How the researchers proceeded

The study was based on a retrospective analysis of the medical records of 30,490 children from the Olmsted County, Minnesota, birth cohort. Among them, 257 children, or 0.84%, had been diagnosed with epilepsy before the age of 19. The researchers compared ASD prevalence using different diagnostic definitions — broad research criteria, stricter criteria and clinical diagnosis — in order to ensure the robustness of the results. 

Results that raise questions

The data show a clear increase in autism prevalence among children with epilepsy, regardless of the criteria used: 

• 21.4% versus 3.2% according to broad criteria
• 14.0% versus 1.6% according to strict criteria
• 7.9% versus 0.7% for clinical diagnosis

  Beyond this overrepresentation, several factors distinguished children with both conditions. They were more likely to have intellectual disability — 56.5% versus 15.4% — more often girls — 38.2% versus 25.8% — and received an autism diagnosis earlier, at 7.4 years compared with 8.7 years.

Better screening to act earlier

These results suggest that overall neurodevelopmental severity could play a key role in this comorbidity. Intellectual disability appears in particular to be an important marker, possibly reflecting more diffuse or earlier brain involvement. In addition, the higher proportion of girls is noteworthy, in a context where autism is usually underdiagnosed in girls.  

The authors emphasize the practical implications of these observations. “These observations highlight clinically relevant differences within this group and underline the importance of early recognition of developmental issues,” Mariya Saify said in a press release.  

However, despite this increased risk, ASD diagnosis may still remain delayed in children with epilepsy. As Dr. Elaine C. Wirrell notes: “Our findings emphasize the importance of autism screening in this population in order to promote early diagnosis and timely intervention, two essential elements for improving long-term outcomes.”  

This study confirms the existence of a strong link between epilepsy and autism, while highlighting associated factors such as intellectual disability, female sex and age at diagnosis. These elements support systematic screening for neurodevelopmental disorders in children with epilepsy.  

The findings also raise the question of biological mechanisms common to both conditions, whether genetic, structural or functional. Future research will need to explore these avenues to better understand developmental trajectories and, ultimately, propose more targeted care strategies.  



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About the Author – Elodie Vaz
Health journalist, CFPJ graduate (2023).
Élodie explores the marks diseases leave on bodies and, more broadly, on human life. A registered nurse since 2010, she spent twelve years at patients’ bedsides before exchanging her stethoscope for a notebook. She now investigates the links between environment and health, convinced that the vitality of life cannot be reduced to that of humans