pdd epilepsy judith bluvstien
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This presentation was part of the 2010 faces (Finding A Cure for Epilepsy and
Seizures) sponsored Event Lecture Series. For more information about faces
please visit us at www.nyufaces.org
Pervasive Developmental Disorder,
Autistic Spectrum Disorder and
Epilepsy: What is the link?
Judith Bluvstein, MD
Assistant Professor of Neurology
What is PDD/ASD?What is PDD/ASD?
Wide spectrum of lifelong neurological conditions that affect socialization and communication:
Impaired social interaction Verbal and non verbal language disorder Deficit in abstract thinking Restricted interests and behaviors
Wide spectrum of lifelong neurological conditions that affect socialization and communication:
Impaired social interaction Verbal and non verbal language disorder Deficit in abstract thinking Restricted interests and behaviors
So… how does it impact?
Social reciprocity (social interaction)
Communication realm (language)
Abstract thinking (imaginative play, later on academics)
So… how does it impact?
Social reciprocity (social interaction)
Communication realm (language)
Abstract thinking (imaginative play, later on academics)
Specific disordersSpecific disorders
Autism
Asperger’s disorder
Childhood disintegrative disorder
Pervasive developmental disorder NOS
Autism
Asperger’s disorder
Childhood disintegrative disorder
Pervasive developmental disorder NOS
How to recognize it?How to recognize it?
Mode A:
Child with developmental delay with more obvious social deficits as time goes by
Mode B:
Child with language/social/cognitive regression
Mode A:
Child with developmental delay with more obvious social deficits as time goes by
Mode B:
Child with language/social/cognitive regression
On a day to day?On a day to day?
How frequent is it?How frequent is it?
3-6:1000 ASD 10-15:10000 Autistic disorder Latest increase may be due to improved and
earlier recognition, possible overdiagnosis, etc
Boys:girls 3-4:1
3-6:1000 ASD 10-15:10000 Autistic disorder Latest increase may be due to improved and
earlier recognition, possible overdiagnosis, etc
Boys:girls 3-4:1
Many, many theories…Many, many theories…
Hormonal theory (Dr Baron Cohen’s fetal testosterone theory)
Toxic theory (heavy metals, thimerosal)
Diet/nutritional theory (gluten/casein/lactose)
Immune system theory (vaccines, fevers)
“Refrigerator mother” theory (Leo Kanner late 40’s)
Hormonal theory (Dr Baron Cohen’s fetal testosterone theory)
Toxic theory (heavy metals, thimerosal)
Diet/nutritional theory (gluten/casein/lactose)
Immune system theory (vaccines, fevers)
“Refrigerator mother” theory (Leo Kanner late 40’s)
DiagnosisDiagnosis
See a pediatric neurologist
Think about genetics
Think about metabolism
Visualize the brain
Rule out what can’t be seen in daytime
See a pediatric neurologist
Think about genetics
Think about metabolism
Visualize the brain
Rule out what can’t be seen in daytime
Some genetic causesSome genetic causes
Tuberous Sclerosis Fragile X syndrome Rett’s syndrome Angelman
Tuberous Sclerosis Fragile X syndrome Rett’s syndrome Angelman
Some metabolic causesSome metabolic causes
What makes proteins What makes fat Sugars Our cell’s lungs
What makes proteins What makes fat Sugars Our cell’s lungs
What is Epilepsy?What is Epilepsy?
Many seizures Abnormal brain waves
Many seizures Abnormal brain waves
What is a seizure?What is a seizure?
Abnormal electrochemical “communication” between neurons
They look different based on location
Abnormal electrochemical “communication” between neurons
They look different based on location
Is there more than one type?Is there more than one type?
Focal Generalized Focal with secondary generalization
Focal Generalized Focal with secondary generalization
Causes of EpilepsyCauses of Epilepsy
Familial Infections Structure Injuries Metabolic Others still unknown in 2010
Familial Infections Structure Injuries Metabolic Others still unknown in 2010
PDD and EpilepsyPDD and Epilepsy
Increased risk of epilepsy 7 to 46 % higher risk The more neurological compromise, the
more of a chance of epilepsy More common when an organic cause is
found
Increased risk of epilepsy 7 to 46 % higher risk The more neurological compromise, the
more of a chance of epilepsy More common when an organic cause is
found
Remain alert!Remain alert!
Kids with autism may not be able to tell a seizure
Medications should be managed very very carefully
Sleep should be screened Some medications for seizures can help
behavior
Kids with autism may not be able to tell a seizure
Medications should be managed very very carefully
Sleep should be screened Some medications for seizures can help
behavior
Excerpt from "Born on a Blue Day”by Daniel Tammet
Excerpt from "Born on a Blue Day”by Daniel Tammet
“I was born on January 31, 1979 -- a Wednesday. I know it was a Wednesday, because the date is blue in my mind and Wednesdays are always blue, like the number 9 or the sound of loud voices arguing. I like my birth date, because of the way I'm able to visualize most of the numbers in it as smooth and round shapes, similar to pebbles on a beach. That's because they are prime numbers: 31, 19, 197, 97, 79 and 1979 are all divisible only by themselves and 1. I can recognize every prime up to 9,973 by their "pebble-like" quality. It's just the way my brain works.”
“I was born on January 31, 1979 -- a Wednesday. I know it was a Wednesday, because the date is blue in my mind and Wednesdays are always blue, like the number 9 or the sound of loud voices arguing. I like my birth date, because of the way I'm able to visualize most of the numbers in it as smooth and round shapes, similar to pebbles on a beach. That's because they are prime numbers: 31, 19, 197, 97, 79 and 1979 are all divisible only by themselves and 1. I can recognize every prime up to 9,973 by their "pebble-like" quality. It's just the way my brain works.”
Thank you!Thank you!