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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: autism and seiuresForum: Neurology Forum
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Re: autism and seiuresPosted by ccf neuro M.D. on May 26, 1997 at 13:44:22: In Reply to: autism and seiures posted by Cynthia Phillips on May 19, 1997 at 22:00:33:
: My son had his first seizure Feb. 14 of this year. He is 10 years old and was diagnosed autistic at the age of three. His seizure was at school and observed by his regular ed. teacher and school nurse. My husband was able to be there within minutes and observed a great deal of it. I myself come from a nursing background and have witnessed many seiures but am not truly familiar with the terminology etc. What I have seen in the past in patients was either a series of convulsions I would describe as 'flailing' of the limbs and tremors or rhythmic contractions of the limbs. Both of these usually had teeth clenching, urinary incontinence, and sometimes an incontinence of the bowels. Last night our son had his second seizure that we are aware of. His pupils did dilate and he was partially nonresponsive. There was no flailing or contracting or clenching of his teeth, yet he was obviously in distress. He worked his hands constantly and did have maybe 3-5 leg tremors. He made strange swallowing noises. My husband said this was similar to the first episode but much less severe. The first time it took him approximately 45 minutes to an hour to respond at all, this time it was about 30 minutes and he was able to 'connect' with us to some degree even during the seizure. I am interested in whatever info you can provide on seizures and especially as related to children with autism. Thank you. PS Following the first seizure we were referred to a neurologist who said "I am unfamiliar with any connection between autism and seizures"... and suggested we wait for another seizure... = Cynthia, A very interesting question. I have found at least two articles in the recent medical literature that confirm a link between autism and epilepsy. The best series of patients (314) found an overall epilepsy incidence of 14% in autistic patients, and 11% in autistic boys specifically. The risk of epilepsy was associated with those children having more severe cognitive and motor deficits. Certainly all of the episodes you describe sound like seizures. The second sounds like a type of seizure generally known as "partial complex" but more precisely in the Cleveland Clinic epilepsy classification system as an automotor seizure. The funny repetitive or stereotyped movements your husband observed are known as automatisms. Generally such seizures originate from the temporal lobe, but may come from the frontal lobe of the brain as well. Your son needs to see a pediatric neurologist FAST, and will require workup to characterize the precise nature of his epilepsy and best treatment options for it. If you are anywhere near Cleveland, I would strongly suggest seeing a Dr. Elaine Wyllie, who is a world renowned expert in pediatric epilepsies, or Dr. A David Rothner, chairman of the pediatric neurology department who has considerable interest and expertise in both autism and epilepsy. If Cleveland is far away for you, I would get him to the nearest LARGE teaching institution/medical center, even if you have to wait a while. This problem will be a complex one to define and treat and is best handled from the start by an expert. If you would be interested in seeing Dr. Rothner or Dr. Wyllie, the pediatric neurology appointmant desk number is 216-445-8125 or 1-800-223-2273 extension 58125. By the way, if you or your son's current physician are interested in the article I mentioned the reference is the journal Pediatrics vol 88 (no. 6) pages 1219-1225; December 1991 issue. I hope this information is helpful to you.
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