Étude de la comorbidité : Trouble du spectre autistique et epilepsie, à propos d’une enquête prospective à l’EHS Ain Abessa, Sétif.

Abstract

Introduction This prospective study explores the comorbidity between Autism Spectrum Disorder (ASD) and epilepsy in Algeria, a context characterized by disparities in healthcare access and in research. The objectives are: (1) to determine the of ASD- epilepsy comorbidity, (2) to identify associated clinical and contextual factors, and (3) to propose a protocol tailored to the specificities of the local healthcare system. Methods Over a 12-month period, 129 children and with ASD (aged 2–17 years) were recruited at EHS Ain Abessa (Sétif). Binary logistic regression with LASSO regularization (AUC = 0.9) and exact statistical tests (Fisher’s test, Clopper-Pearson method) were used to assess associations. Clinical data (ASD severity, seizure patterns), developmental factors (delays, regression), and contextual elements (healthcare accessibility) were systematically collected and analyzed. Results This 12-month prospective observational study, conducted at EHS Ain Abessa (Sétif, Algeria) on 129 children and adolescents with ASD, makes a significant contribution to clinical neuroscience by identifying a distinct Algerian phenotype and proposing a standardized, personalized protocol for ASD-epilepsy . The study also highlights unexpected findings by predominant contextual factors. The identified phenotype, with a prevalence of 45% (58/129, 95% CI: 36.2–53.9%, χ² = 38.2, p < 0.001), is strongly associated with severe forms of ASD (OR = 2.8, 95% CI: 2.–4.1, p < 0.001, Table P80) and a set of robust clinical predictors: early-onset, uncontrolled epilepsy predominantly affecting children aged 2–5 years (OR = 4.5, 95% CI: 3.10–6.7, p < 0.001, Table P81); severe epilepsy characterized by daily seizures (OR = 5.1, 95% CI: 3.4–7.6, p < 0.001, Table P81); a significantly higher prevalence of global language delay in the comorbid group (OR = 5.9, 95% CI: 2.5–13.6, p < 0.001, Table P46); developmental regression predominantly observed in ASD cases with epilepsy (OR = 3.8, 95% CI: 2.7–5.5, p < 0.001, Table P81); significantly higher rates of delay (OR = 2.8, 95% CI: 1.4–5.9, p = 0.004, Table P40); and severe/profound intellectual disability, exclusively found in the comorbid group (OR = 6.5, 95% CI: 0.80–54.3, p = 0.06, Table P41). This profile, further shaped by age-related dynamics (severe epilepsy declining from 71% to 0% between ages 2–5 and 13–17 years, χ² = 38.2, p < 0.001, Table P30), reflects a unique neurodevelopmental vulnerability exacerbated by major contextual factors. These include an average diagnostic delay of 3.2 years (OR = 1.8, 95% CI : 1.2–2.6, p = 0.01, Table P81), the presence of consanguinity as a culturally relevant but statistically limited factor (OR = 1, 95% CI: 0.5–2.2, p = 0.8, Table P81 Bis), and a pronounced rural-urban disparity, with comorbid cases being overrepresented in rural areas (56.9%, p = 0.06, Table P14) compared to a predominance of ASD-only cases in urban (59.2%, Table P14).