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Suggest Treatment For Seizure And Autism Spectrum Disorder

Posted on Fri, 7 Nov 2014

Question: 12-year old autistic son is experiencing what appear to be some form of seizure or episode that causes him to punch his forehead and top of head (as if in extreme pain), then goes into crying or laughing spells, appears disoriented/scared and becomes extremely agitated, destructive and aggressive. The episodes last anywhere from a minute to 2 hours or more. Could some form of abnormality of the frontal lobe cause this? Psychiatrist and pediatrician will not even entertain referring for MRI or other brain study, chalking up the outbursts and behaviors to autism spectrum disorder. He is currently taking a cocktail of anti-psychotics which do not seem to be helping. Any feedback/insight is greatly appreciated . . . I'm at the end of my rope!

Answered by Dr. Sudhir Kumar (39 minutes later)

Brief Answer:
Suggestive of complex partial seizures.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your son's symptoms and I appreciate the excellent description of the events.

These are suggestive of complex partial seizures. The most likely origin could be temporal or frontal lobes.

He would benefit from MRI brain epilepsy protocol and EEG studies.

In the meanwhile, a trial of anti-epileptic drugs such as oxcarbazepine may be given.

I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.

Wishing you good health,

Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (1 hour later)

How would oxcarbazepine interact with other medications he's presently taking? Based on my observations, it seems the more recently prescribed medications (Geodon, Lithium) are doing more harm than good.

Answered by Dr. Sudhir Kumar (53 minutes later)

Brief Answer:
Oxcarbazepine is safe.

Detailed Answer:
Thank you for getting back.

Oxcarbazepine is safe, when used with anti-psychotics and there are no significant drug interactions.

I agree with you that his current medications may cause more harm, as they may aggravate seizures.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (6 hours later)

Thank you so much, Dr. XXXXXXX for not dismissing my concerns and queries. My son is non-verbal (has echolalia) and cannot express what he's experiencing (mentally or physically). I am only able to act on motherly instincts. Are any of the following medications my son's taking now advisable when seizures might be possible: Lithium Carbonate (300 mg capsules, 1 in am, 2 in pm); Geodon (40 mg in a.m. and noon; 80 mg at bedtime); Clonidine HCL 0.1 mg tablet (1 in a.m. and 3 in p.m.); Ziprasidone HCL 80 mg (1 at bedtime); Hydroxyzine HCL 50 mg (1 at bedtime); Melatonin 3 mg (at bedtime). It takes a lot of effort to get him to take all dosages consistently and he seldom has interrupted sleep.

Your professional candor is greatly appreciated and respected.

Gratefully,
XXXXXXX

Correction: He seldom has uninterrupted sleep (awakens several times during night or doesn't sleep at all).

Answered by Dr. Sudhir Kumar (10 hours later)

Brief Answer:
These medications may be continued.

Detailed Answer:
Thank you for getting back.

These medications at the current dosage may be continued along with anti-seizure medications.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar