Autism One 2009 Conference Chicago, Il. May, 2009: Unprovoked Seizures In Autistic Individuals
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Autism One 2009 Conference Chicago, IL. May, 2009 Unprovoked Seizures in Autistic Individuals
Tapan Audhya, PhD New York University, NY & Vitamin Diagnostics, NJ
Seizure (Sudden, Abnormal electrical activity in brain)
Partial seizure (Focal, sensory or petit mal) (one part of brain; particularly the site which directs “flight” response; conscious; either tonic or clonic)
Simple
Generalized seizure (Both site of brain) Unconscious; Both tonic and clonic
Complex
(No loss of consciousness) Epilepsy – a recurrent seizure Non-epileptic Seizure – Similar to epileptic. Seizure but not caused by electrical disruption of cerebral cortex. Classified as 1) physiologic or 2) psychogenic
Nutritional Status of Autistic Children with Seizure Age Group 4 -16 years ; N = 89 (Boys - 66, Girls – 23) Repetitive Epileptic Seizure 1-7.2 min (mean – 4.0 min) 3 - 4 times a day ICD-9 → 345.4;345.9;343.4;299.0 Epileptic Seizure was confirmed by EEG on 29 boys and 5 girls 17 children had spinal tap for unrelated reason
Vitamins & Minerals Vitamin B1 in Plasma 32 low, 57 normal
Vitamin B6 in Plasma 30 low, 40 high, 44 low in P-5-P
Biotin in Plasma 23 low, 43 normal These children were also hypoglycemic
Folic Acid in Plasma Low only in those children who take anticonvulsant medication. 11 children had problem with impaired transport of folate across the BBB. 8/14 low in CSF
Vitamin E in Plasma 45 low, 2 high, 42 normal
Vitamin D in Plasma 27 low in D3; (all of them had anticonvulsant medication) Minerals
Magnesium 39 low in plasma 19 low in RBC 10 low in WBC 10/17 low in CSF
Selenium 8/17 low in CSF 20 low in Plasma
Manganese 32 low in plasma & RBC
Calcium 10/17 high in CSF 16 low in Plasma 5 high in RBC
Protein & Amino Acids Prolactin
199 amino acid, Hypothalamic peptide & controlled by Dopamine 21 boys and 3 girls had high plasma prolactin (2 -3x the normal levels) 11 boys & 3 girls had low Dopamine
Glutamate
14/17 high glutamate in CSF, 42 high in Plasma
Aspertate
14 high in Plasma & CSF
Taurine
10/17 low in CSF, 34 low in Plasma
GABA
13/17 low in CSF, 28 high in Plasma, 59 low in Plasma
Synthesis of GABA and α-
Ketoglutarate
Decarboxylase
Glutamine → Glutamate
P-5-P
Transaminase P-5-P
GABA α-Ketoglutarate
Glutathione Peroxidase 26 low normal 34 less than half the normal value Free Radical Oxygen SOD
H202 Glutathione Peroxidase (GP)
H20 + 02
GSH
GP GR
GSSG
Autism, Seizure & Neurotransmitters (NT) NTs are chemicals that transfer information from one neuron to another NTs have two basic functions • Inform receiving neuron to “Fire” • Inform receiving neuron to stop “Firing”
Excitatory Inhibitory
These actions of NTs depend on a class of proteins which is known as receptors. These receptors initiate the activity after receiving the NTs. GABA, for example, binds to receptors which are inhibitory. Most anti anxiety medications increase GABA transmission More GABA receptor activation Shut down the CNS Relaxation
GABA Receptor
GABAergic system in cerebellum and limbic structure in affected in autism. Inhibition of this system is suppressed by 2. Impairment of GABA-receptor 3. Antagonism of GABAergic neurons bearing receptors sensitive to glutamate analog NMDA. Example: Pathology relating to GABA receptors and suspected etiologies of autism Excessive glutamate activation of non-NMDA glutamate receptor – Pathology observed in Autism
GABA Receptor submit Genes in Autism Chromosome 4p12
GABA-receptor Subunit Gene GABRG1 -A2 -A4 -B1
5q34
-B2 -A6 -A1 -G2 -P
6q15
-R1 -R2
15q12
-A5 -B3 -G3
Only GABR A4 is involved in the etiology of autism and gene – gene interaction between GABR A4 and GABR B1
GABAA
Receptor
GABAA Receptor
Controlling Seizures by Nutritional Approach Ketogenic Diet : A diet high in fats, low in protein and carbohydrate. Fat: (carb + protein) = 4:1 However, never make too low carb (Hypoglycemia) Medium chain Triglycerides (MCT) are more ketogenic.
Taurine 500 mg/day; divided in batches Folic Acid3 400 mcg/day
Vit – B1 20 mg/day
Vit B6 20 mg/kg Body wt.
Mg 400 mg/day
Mn 5 mg/day
Zn 20 mg/day
DMG 100 mg/day
Se 100 mcg/day
L-Carnitine 100 mg/day
Vit. E (natural) 100 mg/day
L-carnosine 250 mg/2 x day
Vit – B12 200 mcg/day
Tapan Audhya, PhD New York University, NY & Vitamin Diagnostics, NJ
Seizure (Sudden, Abnormal electrical activity in brain)
Partial seizure (Focal, sensory or petit mal) (one part of brain; particularly the site which directs “flight” response; conscious; either tonic or clonic)
Simple
Generalized seizure (Both site of brain) Unconscious; Both tonic and clonic
Complex
(No loss of consciousness) Epilepsy – a recurrent seizure Non-epileptic Seizure – Similar to epileptic. Seizure but not caused by electrical disruption of cerebral cortex. Classified as 1) physiologic or 2) psychogenic
Nutritional Status of Autistic Children with Seizure Age Group 4 -16 years ; N = 89 (Boys - 66, Girls – 23) Repetitive Epileptic Seizure 1-7.2 min (mean – 4.0 min) 3 - 4 times a day ICD-9 → 345.4;345.9;343.4;299.0 Epileptic Seizure was confirmed by EEG on 29 boys and 5 girls 17 children had spinal tap for unrelated reason
Vitamins & Minerals Vitamin B1 in Plasma 32 low, 57 normal
Vitamin B6 in Plasma 30 low, 40 high, 44 low in P-5-P
Biotin in Plasma 23 low, 43 normal These children were also hypoglycemic
Folic Acid in Plasma Low only in those children who take anticonvulsant medication. 11 children had problem with impaired transport of folate across the BBB. 8/14 low in CSF
Vitamin E in Plasma 45 low, 2 high, 42 normal
Vitamin D in Plasma 27 low in D3; (all of them had anticonvulsant medication) Minerals
Magnesium 39 low in plasma 19 low in RBC 10 low in WBC 10/17 low in CSF
Selenium 8/17 low in CSF 20 low in Plasma
Manganese 32 low in plasma & RBC
Calcium 10/17 high in CSF 16 low in Plasma 5 high in RBC
Protein & Amino Acids Prolactin
199 amino acid, Hypothalamic peptide & controlled by Dopamine 21 boys and 3 girls had high plasma prolactin (2 -3x the normal levels) 11 boys & 3 girls had low Dopamine
Glutamate
14/17 high glutamate in CSF, 42 high in Plasma
Aspertate
14 high in Plasma & CSF
Taurine
10/17 low in CSF, 34 low in Plasma
GABA
13/17 low in CSF, 28 high in Plasma, 59 low in Plasma
Synthesis of GABA and α-
Ketoglutarate
Decarboxylase
Glutamine → Glutamate
P-5-P
Transaminase P-5-P
GABA α-Ketoglutarate
Glutathione Peroxidase 26 low normal 34 less than half the normal value Free Radical Oxygen SOD
H202 Glutathione Peroxidase (GP)
H20 + 02
GSH
GP GR
GSSG
Autism, Seizure & Neurotransmitters (NT) NTs are chemicals that transfer information from one neuron to another NTs have two basic functions • Inform receiving neuron to “Fire” • Inform receiving neuron to stop “Firing”
Excitatory Inhibitory
These actions of NTs depend on a class of proteins which is known as receptors. These receptors initiate the activity after receiving the NTs. GABA, for example, binds to receptors which are inhibitory. Most anti anxiety medications increase GABA transmission More GABA receptor activation Shut down the CNS Relaxation
GABA Receptor
GABAergic system in cerebellum and limbic structure in affected in autism. Inhibition of this system is suppressed by 2. Impairment of GABA-receptor 3. Antagonism of GABAergic neurons bearing receptors sensitive to glutamate analog NMDA. Example: Pathology relating to GABA receptors and suspected etiologies of autism Excessive glutamate activation of non-NMDA glutamate receptor – Pathology observed in Autism
GABA Receptor submit Genes in Autism Chromosome 4p12
GABA-receptor Subunit Gene GABRG1 -A2 -A4 -B1
5q34
-B2 -A6 -A1 -G2 -P
6q15
-R1 -R2
15q12
-A5 -B3 -G3
Only GABR A4 is involved in the etiology of autism and gene – gene interaction between GABR A4 and GABR B1
GABAA
Receptor
GABAA Receptor
Controlling Seizures by Nutritional Approach Ketogenic Diet : A diet high in fats, low in protein and carbohydrate. Fat: (carb + protein) = 4:1 However, never make too low carb (Hypoglycemia) Medium chain Triglycerides (MCT) are more ketogenic.
Taurine 500 mg/day; divided in batches Folic Acid3 400 mcg/day
Vit – B1 20 mg/day
Vit B6 20 mg/kg Body wt.
Mg 400 mg/day
Mn 5 mg/day
Zn 20 mg/day
DMG 100 mg/day
Se 100 mcg/day
L-Carnitine 100 mg/day
Vit. E (natural) 100 mg/day
L-carnosine 250 mg/2 x day
Vit – B12 200 mcg/day
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