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What are the possible causes of the development of an unsteady gait in ...
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What are the possible causes of the development of an unsteady gait in an adult male with autism?

     After doing a considerable amount of research and consulting with physicians for almost a decade, my family has not been given a cause for the development of an unsteady gait in my brother.  His health condition is undoubtedly complex, so I am aware that no definitive answer can be provided via the internet.  Nevertheless, an absence of answers or directions necessitates that I use any method available to acquire help, because my brother's condition is steadily declining.  

     My brother was diagnosed with autism and moderate mental retardation as a baby.  The doctors gave him a poor prognosis, but he made dramatic and unexpected developments in childhood and adolescence.  He learned to independently execute household chores, cook a plethora of meals, participate and excel in basketball, and develop an exceptional talent for video games. He also displayed dramatic improvements in social skills and made friends as an adolescent (in spite of limitations in verbal communication).  Cognitively, my brother is on the level of a younger elementary student.  

     After my brother turned 21, my mother and I began to notice changes in his fine motor capabilities.  The first sign I noted was he was unable to stir a beverage due to pronounced hand tremors.  Therefore, his physicians initially suspected a medication induced parkinsonian-like condition (They initially suspected Depakote as the cause).  His medications were altered and reduced over the years, but his condition is steadily deteriorating.  

    My brother is now 30, and he walks with an abnormal gait. He leans backwards when walking and standing, and his lack of fine motor movement causes him to have difficulty eating foods without spilling them.  His backwards lean while sitting causes him to constantly readjust his body to prevent sliding out of a chair.  However, no abnormal movement is noted while he is sleeping, and he is able to slightly straighten his posture upon running a short distance.  Like many people with autism, he has some OCD tendencies which include continuously touching objects.  Before this onset, it was impossible to visually identify my brother as having a developmental problem unless you spoke with him.    

     My brother is now in a group home, and he has access to a team of physicians who have been unable to diagnose his condition (He has access to physicians at Duke and UNC Chapel Hill). Although he now wears a back brace, he has experienced two falls within the last six months. I also believe he is having frequent headaches.  

I am providing some additional information that may help:  

* He was born premature.

* My brother also was diagnosed with bipolar disorder after entering puberty. His bipolar disorder became increasingly difficult to manage at home, and his manic states increased in severity over the years. The rapid cycling steadily increased until his early twenties, and they are now less extreme.

* He had an MRI one month ago, and the results were normal.    

* He takes an array of medications for bipolar disorder including Depakote, Abilify, and Lithium.

*  He has taken Zyprexia and Seroquel in the past.

*  last year, he lost an average of 10 pounds every month,  on a 5,00 kcal daily diet, until he weighed 140 lbs at six
feet.  No cause of his weight loss was identified.  

* He also takes Synthroid and vitamin E (Although he takes Synthoid, he does not have a diagnosed
  thyroid condition).  

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I read somewhere about a condition called mitochondrial dysfunction having connections with some children/adults with autism.  This appears to be a secondary condition that can become active at any age and can cause a deterioration.  I am not a professional, just another parent - but google it to see if it sounds possible.
Some of his symptoms might be down to Sensory Integration Disorder, I presume an OT has assessed him?  Sometimes if the senses get very out of balance it causes alot of behaviours and appearing to regress because they are simply unable to process the sensory information coming in and accomodate it.  The senses are sight, sound, touch, taste, smell, balance and co-ordination.  However even if this is playing a part, the symptoms you describe sound too severe so there is probably other things going on as well.
Regarding his medication, are any of them known to cause motor problems or postural tics?  
There is a kind of skizophrenia that involves unusual posture.  I am not suggesting it is that, but it might be worth looking into especially as he has bi-polar as well.
I'm sorry you're having such a hard time.  It must be awful to see him deteriorating over this amount of time.
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730414_tn?1403956473
I have to be quick...Try googling Normal Pressure Hydrocephalus (NPH). I read in my neurologists office about it just 2 days ago. I don't know if it will help.
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