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!