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Living with Autism

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December 2, 2015

Medical Mysteries in Autism: The Search for Answers

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                          As any parent of an autistic adult child has, I've spent years reading books, talking to doctors, mulling over scientific studies, secretly sobbing, pulling my hair out (sometimes literally) trying to figure out how to better help my autistic son.

Add to that, going to numerous Administrative Law court hearings to fight for my son's right to proper supports and services.

Because my autistic son has seizures AND self-injurious behavior (SIB), I have often asked myself, do these two seemingly unrelated issues have any connection?

For example, I've noticed during my son's most severe self-injurious meltdowns, his seizure activity sometimes disappears for a few days. Of course there were other times when he had both SIB and seizures on the same day, which makes this even more complicated, but when you see one in the absence of the other, it's worth asking, why?

For example, when seizure activity returns, self-injurious behavior can (not always) disappear for a few days. What kind of medical mystery are we dealing with here?

Are SIB and seizures rooted in neurons that depend on and work together, but when one is faulty these neurons get locked in a battle between inhibitory and excitatory functions--- creating a constant war for peace in the brain? What is the connection between SIB and seizure activity?

I noticed long ago that Ativan doesn't work for my son's SIB, it actually INCREASES my autistic son's self-injurious behavior.

Conversely, Ativan works great if he's having acute tonic clonic seizure activity, but give too much Ativan he comes out of seizure and starts in with SIB.

 If Ativan increases my autistic son's SIB, is it because when neurons in his brain are TOO INHIBITED by a benzodiazepine--such as Ativan--this deactivates areas in brain (i.e. choline) that need to be slightly activated to suppress self-injurious behavior?

If Ativan, a benzodiazepine targeting GABA receptors, inhibits transmission  in the locus coeruleus, could that explain an increase in SIB after loads of Ativan for seizures?

Interestingly, a study shows that self-injurious behavior can be rooted in INHIBITION of locus coeruleus (part of brain that helps you stay alert) and when it's ACTIVATED, the self-abuse decreases.

Incidentally, locus coeruleus promotes brain homeostasis and is connected to basal lateral amygdala.

Additional research shows STIMULATING basal lateral amygdala-- decreases SIB.


Another interesting fact: There's a few cases showing when nicotine patches are applied to people with a rare genetic (ADFLE) mutation causing epilepsy, the patch stops the seizures. Fascinating.

In short, these people actually NEED nicotine supplementation, because specific receptors in their brain are dysfunctional, causing a subsequent IMBALANCE in other receptors, which leads to having constant seizures.

Supplementing nicotine effectively treats their seizures.

This is mindblowing stuff. Shows how little we really know about the autism, seizures, brain, behavior connection.

Even more interesting is research showing nicotine patches can reduce aberrant behavior in autistic patients.

Why would nicotine, of all things, be involved in decreasing BOTH self-injurious behavior AND epilepsy?

This further prompts us to challenge the typical treatment of autism with benzos. The autistic brain does NOT want or need to be constantly sedated.


Even with autism and epilepsy, we must LIMIT the use of sedatives and continue to support research involving brain receptors involved in autism, epilepsy and self-injurious behavior.

Kim Oakley


Sources:

http://www.wndu.com/mmm/headlines/Nicotine-patch-alleviates-seizures-for-5-year-old-girl-285652591.html

http://yaledailynews.com/blog/2015/11/03/nicotine-reduces-aggressive-episodes-in-mice-and-children-with-autism/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549527/