Abstract Details

Title Epilepsy with Developmental Delay and Intellectual Disabilities – Clinical, Radiographic, Electroencephalographic Features in Adults with Epilepsy

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P11 - Poster Session 11 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-017

Objective We aimed to evaluate the clinical, EEG, and radiologic features associated with developmental delay/intellectual disabilities (DD/ID) in adult patients with epilepsy.

Background DD and ID may co-occur in patients with epilepsy. Understanding the clinical features of these patients can help to optimize the management.

Design/Methods This retrospective chart review identified 382 patients with DD/ID evaluated from 2017-2024. The database was stratified based on epilepsy type, comorbidities, EEG findings, MRI, and anti-seizure medications used both as monotherapy and in polytherapy.

Results DD/ID were found in 382 out of 2,975 patients (12.8%). The cohort included 216 males (56.7%) and 166 females (43.3%) with a mean age of 25.83 ± 18.02 years. Autistic features were present in 96 out of 382 (25.2%) of patients with DD/ID. Most patients (172/382, 46.0%) were diagnosed with focal epilepsy, followed by generalized epilepsy (127/382, 33.8%), while the rest were unclassified. A total of 186 out of 382 patients (49%) had EEG studies available. Among those who had EEGs, 149 (81.8%) showed abnormal findings. Of these abnormal EEGs, 80 (53.6%) exhibited epileptiform discharges, 63 (42.28%) had background slowing, and 4 (2.6%) showed asymmetric slowing. In contrast, 37 patients (19.2%) had normal EEG results.
MRI brain results were available in 126 patients (32.9%). Among the MRI scans, 58 (46%) revealed abnormalities, with cortical dysplasia and callosal atrophy being common findings, while 68 (54%) were normal.
143 patients (37.5%) were on monotherapy, 167 (43.8%) on polytherapy, and 71 patients (18.6%) were not receiving any anti-seizure medication. Levetiracetam remained the most commonly used anti-seizure medication in both monotherapy and polytherapy regimens.

Conclusions Majority of epileptic patients with DD/ID presented focal seizures and abnormal EEG findings, particularly epileptiform discharges and background slowing. Cortical dysplasia was frequently observed as a structural abnormality on MRI. Levetiracetam remains the most frequently used anti-seizure drug.

Authors/Disclosures
Gulbudin Muhammad, MD PRESENTER	Dr. Muhammad has nothing to disclose.
Hira Pervez, MD, MBBS (University of Toledo)	Dr. Pervez has nothing to disclose.
Fahham Asghar, MD (The University of Toledo)	Mr. Asghar has nothing to disclose.
Syed Owais, MD	Dr. Owais has nothing to disclose.
Naeem Mahfooz, MD	Dr. Mahfooz has nothing to disclose.
Ajaz Sheikh, MD (ProMedica Neurosciences Center)	Dr. Sheikh has nothing to disclose.
Imran I. Ali, MD, FAAN (University of Toledo COM)	Dr. Ali has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for ABPN.

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