Autism and Epilepsy??

Autism can present in two ways. In most autistic children, the difference can be recognized from an early age. They move and cry less, they do not like to be held and they are quite happy to be left alone. In approximately one-third of children the development proceeds normally until the second year of life. Then they gradually regress into autism usually in association with emotional or physical trauma and with seizures. Kanner reported one case of epilepsy among his 11 children. The prevalence of epilepsy among autistics is much higher than the normal population. There is also an increased prevalence of abnormal potentially epileptogenic activity in children with autistic spectrum disorder. About one in four autistic children develop seizures at puberty. Hughlings Jackson in 1870 postulated about epilepsy as an intermittent derangement of the nervous system due to “an excessive and disorderly discharge of cerebral nervous tissue on muscles.” This has been supported by modern electrophysiology. As a result of the discharge, there may be an instantaneous loss of consciousness, altered perception or impaired psychic function, convulsive movements, disturbance of sensation, or some combination thereof. Seizure always indicates that the cerebral cortex has been affected by disease, either primary or secondary. Epilepsy is often associated with global central nervous system disorders like cerebral palsy, mental retardation and autism. In autistic children, the risk of seizures increases if they have certain specific neurological disorders like neurofibromatosis, tuberous sclerosis, phenylketonuria (untreated). Children with symptomatic infantile spasms (sudden generalized muscle contractions usually beginning between the ages of three and eight months) tend to develop both epilepsy and autism. Complex partial seizures or temporal lobe epilepsies show different clinical features in children of different ages. The general course tends to be favorable. Adverse course may be seen in children with perinatal complications, spike-wave complexes in the EEG and those with psychomotor and psychosensory seizures. Hashimoto et al reported a tendency for epileptic foci to occur in the frontal region in autistic children and they suggest that frontal dysfunctions may be important in the mechanism of symptoms of autism. Genes Duplications of chromosome 15 have been reported in individuals with atypical autism, varying degrees of mental retardation and epilepsy. Mutations in the Aristaless related homeobox gene (ARX) cause a diverse spectrum of diseases including cognitive impairment, epilepsy and in another group, severe cortical malformations. The precise prevalence of ARX mutation is not known, but may be an important cause of developmental disorders and epilepsy in males which in the future may provide important treatment options Infection A possible association with viral CNS infection with autism and epilepsy has been reported. Nutrition There is also an interesting study which hypothesizes that developing fetuses of pregnant women with deficiency of zinc and excess of copper experience major difficulties in early brain development which may later manifest as schizophrenia, autism or epilepsy. Autism (sometimes called “classical autism”) is the most common condition in a group of developmental disorders known as the autism spectrum disorders (ASDs). Autism is characterized by impaired social interaction, problems with verbal and nonverbal communication, and unusual, repetitive, or severely limited activities and interests. Other ASDs include Asperger syndrome, Rett syndrome, childhood disintegrative disorder, and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS). Experts estimate that three to six children out of every 1,000 will have autism. Males are four times more likely to have autism than females. Children with autism may fail to respond to their name and often avoid eye contact with other people. They have difficulty interpreting what others are thinking or feeling because they can’t understand social cues, such as tone of voice or facial expressions, and don’t watch other people’s faces for clues about appropriate behavior. They lack empathy. Many children with autism engage in repetitive movements such as rocking and twirling, or in self-abusive behavior such as biting or head-banging. They also tend to start speaking later than other children and may refer to themselves by name instead of “I” or “me.” Children with autism don’t know how to play interactively with other children. Some speak in a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking. Many children with autism have a reduced sensitivity to pain, but are abnormally sensitive to sound, touch, or other sensory stimulation. These unusual reactions may contribute to behavioral symptoms such as a resistance to being cuddled or hugged. Children with autism appear to have a higher than normal risk for certain co-existing conditions, including fragile X syndrome (which causes mental retardation), tuberous sclerosis (in which tumors grow on the brain), epileptic seizures, Tourette syndrome, learning disabilities, and attention deficit disorder. For reasons that are still unclear, about 20 to 30 percent of children with autism develop epilepsy by the time they reach adulthood. While people with schizophrenia may show some autistic-like behavior, their symptoms usually do not appear until the late teens or early adulthood. Most people with schizophrenia also have hallucinations and delusions, which are not found in autism.