11 yr old with autism past seizures have sudden loss of memory and personality change over the weekend

My son is 11 yrs old diagnosed with Autism and seizure disorder.  He started puberty at 9 1/2 which at that time he started having partial complex seizures, when these occur his heart goes into "bradycardia" (very low heart rate) and he'll sleep.  3 days ago he started suddenly acting differently, normally he is very talkative, a chatter box, very active, and pretty high functioning.  All of a sudden he started mumbling, and any question I ask him he only answers by stating his full name.  He does not seem to remember the answers to common questions he has always known such as his age, or birthdate, or even his address, he can't answer what he wants to eat, he just stairs blankley or states  his name.  He is walking extremely slow and stops if there is a change of floor like carpet to tile, he is acting very confused and just looks at you blankley.  He normally concentrates and has a terrific memory and can answer anything that he has been taught.  Not so anymore and this all happened suddenly.  I thought at first seizures but this has been going on for almost 4 days now.  He was even eating food yesterday that he normally would never touch, he is even sleeping awkwardly, straight as a board rather than curled up as usual.  His medication hasn't change, nothing has changed that might have brought this on, but I am extremely concerned as this happened so suddenly and is not getting better.  Any ideas as to what is going on?

[Shazia Alam, DO]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Given the acuity of your son’s symptoms with his clinical history, I would still be concerned whether he is having subclinical seizures (seizures in which there is no shaking or clinical signs of a seizure).  Some of his confusion could be post-ictal confusion, where he is having these “silent” seizures and is disoriented afterwards, which is what you are seeing.  Other considerations to look at is whether or or not his medication levels are toxic.  I know you mentioned that there have been no changes in his medications, however since he just underwent puberty, some of his hormones may be competing with his medication in his blood, causing higher levels than normal, which can also make him confused.  Other considerations would include side effects of his medications, such as high ammonia levels, low sodium—these are general side effects to some seizure medications, since I do not know which medications your son is on.  

I would recommend having your son seen by his doctor/neurologist as soon as possible.  

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.