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Integration of EEG Into Psychiatric Practice: A Step Toward Precision Medicine for Autism Spectrum Disorder

Swatzyna, Ronald J.*; Tarnow, Jay D.*; Turner, Robert P.; Roark, Alexandra J.*; MacInerney, Erin K.*; Kozlowski, Gerald P.

Journal of Clinical Neurophysiology: May 2017 - Volume 34 - Issue 3 - p 230–235
doi: 10.1097/WNP.0000000000000365
Original Research

Introduction: Data from an EEG is not commonly used by psychiatrists to plan treatment and medication. However, EEG abnormalities such as isolated epileptiform discharges are found to be more prevalent in psychiatric patients, particularly those diagnosed with autism spectrum disorder (ASD). Most medications prescribed for ASD lower seizure threshold and increase side effects. Therefore, it may be prudent to order an EEG for ASD cases, especially those categorized as refractory.

Methods: The data set was obtained from a multidisciplinary practice that treats a wide variety of neuroatypical children and adolescent refractory patients. This study investigated 140 nonepileptic subjects diagnosed with ASD, aged 4 to 25 years. Visual inspection of the EEG was performed to search for paroxysmal, focal, or lateralizing patterns.

Results: Of the 140 subjects, the EEG data identified 36% with isolated epileptiform discharges. The χ2 analysis found no significant difference between genders among the three age groups. Findings indicated a high prevalence of isolated epileptiform discharges among individuals with ASD.

Conclusions: Our results find that compared with the healthy population, a large number of patients with ASD have isolated epileptiform discharges despite never having a seizure. Our findings support the use of EEG in children, adolescents, and young adults with ASD, regardless of gender or age. This is particularly true for those who exhibit aggressive behaviors or those who have failed previous medication attempts with stimulants, antidepressants, and/or antipsychotics.

*Tarnow Center for Self-Management, Houston, Texas, U.S.A.;

Network Neurology LLC, Charleston, South Carolina, U.S.A.; and

Department of Clinical Psychology, Saybrook University, Oakland, California, U.S.A.

Address correspondence and reprint requests to Ronald J. Swatzyna, PhD, Tarnow Center for Self-Management, 1001 West Loop South, Suite 215, Houston, TX 77027, U.S.A.; e-mail:

The authors have no funding or conflicts of interest to disclose.

Presented at the International Society for Neuronal Research 24th Annual Conference, Orlando, Florida, September 24, 2016.

© 2017 by the American Clinical Neurophysiology Society