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Etiology of the epilepsy was known in 32 cases, and included structural lesions, medical history, and developmental and genetic factors. Twenty-nine patients underwent resective treatments (in 8 cases combined with palliative procedures), 24 patients had only palliative treatments, and 3 patients had only subdural electroencephalography. Eighteen of the 56 patients had more than one operation. The mean age at surgery was 11 \u00b1 6.5 years (range 1.5\u201335 years). At a mean follow-up of 47 \u00b1 30 months (range 2\u2013117 months), seizure outcomes included 20 Engel Class I, 12 Engel Class II, 18 Engel Class III, and 3 Engel Class IV cases. The age and follow-up times are stated as the mean \u00b1 SD. Three patients were able to discontinue all antiepileptic drugs (AEDs). Aggression and other aberrant behaviors observed in the clinical setting improved in 24 patients. According to caregivers, most patients also experienced some degree of improvement in daily social and cognitive function. Three patients had no functional or behavioral changes associated with seizure reduction, and 2 patients experienced worsening of seizures and behavioral symptoms.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Epilepsy surgery in patients with autism is feasible, with no indication that the comorbidity of autism should preclude a good outcome. Resective and palliative treatments brought seizure freedom or seizure reduction to the majority of patients, although one-third of the patients in this study required more than one procedure to achieve worthwhile improvement in the long term, and few patients were able to discontinue all AEDs. The number of palliative procedures performed, the need for multiple interventions, and continued use of AEDs highlight the complex etiology of epilepsy in patients with autism spectrum disorder. These considerations underscore the need for continued analysis, review, and reporting of surgical outcomes in patients with autism, which may aid in better identification and management of surgical candidates. The reduction in aberrant behaviors observed in this series suggests that some behaviors previously attributed to autism may be associated with intractable epilepsy, and further highlights the need for systematic evaluation of the relationship between the symptoms of autism and refractory seizures.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.7.peds1651","type":"journal-article","created":{"date-parts":[[2016,11,25]],"date-time":"2016-11-25T15:00:26Z","timestamp":1480086026000},"page":"196-207","source":"Crossref","is-referenced-by-count":23,"title":["Epilepsy surgery in patients with autism"],"prefix":"10.3171","volume":"19","author":[{"given":"Malgosia A.","family":"Kokoszka","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia E.","family":"McGoldrick","sequence":"additional","affiliation":[{"name":"Neurology, Mount Sinai Health System, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maite","family":"La Vega-Talbott","sequence":"additional","affiliation":[{"name":"Neurology, Mount Sinai Health System, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary","family":"Raynes","sequence":"additional","affiliation":[{"name":"Neurology, Mount Sinai Health System, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina A.","family":"Palmese","sequence":"additional","affiliation":[{"name":"Neurology, Mount Sinai Health System, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Wolf","sequence":"additional","affiliation":[{"name":"Neurology, Mount Sinai Health System, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia L.","family":"Harden","sequence":"additional","affiliation":[{"name":"Neurology, Mount Sinai Health System, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saadi","family":"Ghatan","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds1651","series-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM-IV","author":"American Psychiatric Association","year":"1994","unstructured":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: DSM-IV ed 4Washington, DC, American Psychiatric Association, 1994"},{"key":"b2-peds1651","series-title":"Diagnostic and Statistical Manual of Mental Disorders: DSM-5","author":"American Psychiatric Association","year":"2013","unstructured":"American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: DSM-5 ed 5Washington, DC, American Psychiatric Association, 2013"},{"key":"b3-peds1651","series-title":"Epilepsia","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1111\/j.1528-1167.2007.01154.x","article-title":"Behavioral and psychiatric comorbidities in pediatric epilepsy: toward an integrative model","volume":"48","author":"Austin JK,","year":"2007","unstructured":"Austin JK, Caplan R: Behavioral and psychiatric comorbidities in pediatric epilepsy: toward an integrative model. 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