Download - USAAA 071009 final
The Connection Between ASD, Seizures/Epilepsy, And Cognitive Dysfunction - What IF THIS Is Not “Autism?”
Michael J. Goldberg, M.D., F.A.A.P.5620 WILBUR AVENUE, SUITE 318TARZANA, CALIFORNIA 91356TELEPHONE (818) 343 – 1010
www.neuroimmunedr.com
KANNER AUTISM – NOT!!!
Per Dr. Kanner himself, when asked what separated a child with this NEW idea of “Autism” from a child with Schizophrenia, he replied:
“The Child with Autism was NEVER Affectionate”
PAST MEDICAL HISTORY / “ILLNESS” PHOTOSENSITIVY Eczema or hives Frequent ear infections Thyroid or endocrine issues! Sensory processing difficulty Auditory processing difficulties Abnormal EEG or SEIZURE disorder Easily fatigued Wakes tired in AM OCD Fine / Gross motor abnormal
BODY SYSTEMS:
Endocrine Immune Hematology EENT Cardiovascular
Pulmonary GI GU Muscular - Skeletal Neuro
DISEASE MECHANISMS: Metabolic – Toxic
Genetic – Developmental
Tumor - Trauma – Insult
Psychogenic??
Infectious
Immunologic
FACTS vs. FICTION FICTION: “Autism” is NOT an epidemic
– FACT: “Autism” now 1:130 – some 1:88 males • POLIO – 1:1500 – 1:2000 in the 40s / 50s
FICTION: “Autism” is not preventable– FACT: NO recurrence in multiple high risk
families to date – PREVENTATIVE pediatrics FICTION: “Autism” cannot be treated
– FACT: Multiple previous Autism DSMIV 299.0 patients in regular or honor classes
• Oldest patients now in college FICTION: Viral IgG titers are meaningless
– FACT: While not “proving a diagnosis” – chronic elevation implies immune dysfunction or persistent viral infection of some type
SCIENCE SAYS: An epidemic can NOT be due to a
developmental or genetic disorder – SCIENTIFICALLY IMPOSSIBLE!!!
ONE MUST have a disease process
ONLY probable CAUSE – immune and / or viral connection
FACTS vs. FICTION FICTION: “Autism” is NOT an epidemic
– FACT: “Autism” now 1:130 – some 1:88 males • POLIO – 1:1500 – 1:2000 in the 40s / 50s
FICTION: “Autism” is not preventable– FACT: NO recurrence in multiple high risk
families to date – PREVENTATIVE pediatrics FICTION: “Autism” cannot be treated
– FACT: Multiple previous Autism DSMIV 299.0 patients in regular or honor classes
• Oldest patients now in college FICTION: Viral IgG titers are meaningless
– FACT: While not “proving a diagnosis” – chronic elevation implies immune dysfunction or persistent viral infection of some type
“COMPLEX NEURO-IMMUNE,
COMPLEX VIRAL”RENO conf. June 2007
– Top researchers . . “Test tube scientists”• PhD’s / MD’s
– CONCLUSIVE STATEMENTS:• IF toxin, metal, OR “OTHER” specific issue or
trigger present to begin with, NO longer an issue. . .. LEFT WITH “COMPLEX NEURO-IMMUNE, COMPLEX VIRAL”
• NO OTHER FOCUS OF THERAPY EXPECTED TO BE SUCCESSFUL LONGER TERM BEYOND SPECIFIC SYMPTOMATIC TARGETS. . .
N.I.D.S. (Neuro –Immune Dysfunction Syndromes)
For whatever the reasons (genetic, environmental, a combination of viruses, vaccines, allergies, immune system “insults,” etc.), what is occurring appears to be an immune mediated, abnormal “shut down” of blood flow in the brain and therefore central nervous system function.
IMMUNE SYSTEM – ACTIVATED / SUPPRESSED vs. DYSFUNCTIONAL
“COMPLEX NEURO-IMMUNE, COMPLEX VIRAL” FICTION: MITOCHONDRIAL
DYSFUNCTION CAUSES THIS DISORDER
FACT: MITOCHONDRIAL DYSFUNCTION – AND MULTIPLE METABOLIC ABNORMALITIES ARE SECONDARY TO THE IMMUNE SYSTEM DYSFUNCTION (NOT PRIMARY – PATHO-PHYSIOLOGY)
“COMPLEX NEURO-IMMUNE, COMPLEX VIRAL” FICTION: YOU CAN STRENGTHEN
THE IMMUNE SYSTEM BY MULTIPLE SUPPLEMENTS OR MANINPULATIONS
FACT: SINCE THE IMMUNE SYSTEM IS DYSFUNCTIONAL, NOT BROKEN, ANY ATTEMPT TO PUSH IT ONE WAY, IS MORE LIKELY TO PUSH SOMETHING HARMFUL ALSO, THEN CREATE NET HELP
Microglial activation and TNFalpha production mediate altered CNS excitability following peripheral inflammation Riazi K, Galic MA, Kuzmiski JB, Ho W, Sharkey KA, Pittman QJ Proc Natl Acad Sci U S A. 2008 Nov 4;105(44):17151-6
Peripheral inflammation leads to a number of centrally mediated physiological and behavioral changes
We hypothesized that peripheral inflammation leads to increased neuronal excitability from a CNS immune response
Induced inflammation in the gut – To examine - excitability - brain - we administered
(PTZ); TNBS treated showed increased susceptibility to PTZ seizures - strongly correlated with the severity and progression of intestinal inflammation
– Hippocampal slices from inflamed, TNBS-treated - increased spontaneous interictal burst firing - increased intrinsic excitability
Brain
GutImmuneSystem
Neuroglial Activation and Neuroinflammation in the Brain of Patients with AutismDiana L. Vargas, MD, Caterina Nascimbene, MD,1Chitra Krishnan, MHS1Andrew W. Zimmerman, MD, and Carlos A. Pardo, MD Ann Neurol 2005;57:000–000
Active neuroinflammatory process – Past Neuropathological studies – little attention to
immune and neuroglial activity in autism
Responses resemble those seen in neurodegenerative disorders such as Alzheimer's disease (AD), Parkinson's disease (PD), and amyotropic lateral sclerosis, and are similar to those seen in dementia associated with human immunodeficiency virus (HIV) infection– In these conditions, chronic microglial activations
appears to be responsible for a sustained neuroinflammatory response
Supports view - innate immune response
INNATE IMMUNE SYSTEM: STEDMANS MEDICAL DICTIONARY:
– resistance manifested by a species (or by races, families, and individuals in a species) that has not been immunized (sensitized, allergized) by previous infection or vaccination; much of it results from body mechanisms that are poorly understood, but are different from those responsible for the altered reactivity associated with the specific nature of acquired immunity; in general, innate immunity is nonspecific and is not stimulated by specific antigens.
IT’S A COMBINATION OF STRESSES – NOT ONE FACTOR
Alzheimer’s
Anxiety
Adult ADHD
Fatigue
Schizophrenia
ADHD’S
DepressionLD’S
Panic AttacksAsperger
Autism
CFS
Bipolar
The “Real” Bell Curve
Epilepsy - Seizures
NEUR0-IMMUNE Related Disorders
FAMILY “CONNECTIONS”
Mother or Father with CFS or “other” immune mediated disorder
Older child (or two) with ADHD (or other learning disorder LD)
Younger child (or two) with Autism / PDD / Brain dysfunction / seizures
DIAGNOSIS: SPECT SCAN HIGHLIGHTS BLOOD FLOW TO THE BRAIN Once the problem
areas are identified, specific treatments can be implemented
Decreased Blood Flow = Decreased Function
Increased Blood Flow = Increased Function
Pink or green/blue indicates a problem area
SPECT Scan Output
DIAGNOSIS: NEUROSPECT SCAN PINPOINTS AREAS OF DYSFUNCTION – LEANING DIFFICULTIES Severe speech and
language difficulties (left temporal lobe)
Severe social difficulties (right temporal lobe)
Often some fine, not usually gross, motor difficulties (cerebellar involvement)
SPECT Scan Output
10 YR. OLD FEMALEEPILEPSY - ? AUTISM
NK cells 2.8%
sed rate 1
CHILD – DOING WELL/“NORMALIZING”
DOING OK – “BUT NOT GOOD ENOUGH”
CHILD – DOING POORLY:
DAN Protocol - CHELATION:
DAN – IV GLUTAHIONE, HBOT, CHELATION - SEIZURES
Implication: Potential For RecoveryAutism / NIDS If this is a “disease process” and NOT a
developmental disorder, then… Many children diagnosed with ASD were
born with normal brain function that has become dysfunctional
The disease can be addressed and the brain can work normally again - the brain appears to be more pliable than we thought
The importance of early detection and treatment cannot be underestimated . . but the brain IS PLIABLE
“PEDIATRIC” BASED TREATMENTS HAVE SHOWN SIGNIFICANT SUCCESS First: “DO NO HARM” / Hippocratic Oath
Focus on and “attack” the individual components (immune / viral) of the disorder – Food elimination regimens– Antivirals (if indicated)– Antifungals (if indicated)– SSRI’s (almost always indicated)– Antihistamines / allergy control
My clinical approach has been developed over 25 years as a pediatrician
GRADE DISTRIBUTION SHIFTS “UP THE SCALE” FROM INITIAL TO FINAL GRADE NUMBER
Data
Freq
uenc
y
12108642
25
20
15
10
5
0
9.035 1.845 1005.551 2.148 99
Mean StDev N
Initial NUMBERFinal NUMBER
Variable
Histogram of Initial NUMBER, Final NUMBERNormal
Lower GRADE Number (a shift to the LEFT) indicates improvement
ScaleA+ 1A 2A- 3B+ 4B 5B- 6C+ 7C 8C- 9D+ 10D 11D- 12
A
B C D
ADDITIONAL INFORMATION:
Link – Tarzana Hospital Talk – 3/18/09– http://www.tarzanacme.com/video.asp?VidID=
notautism
DVD – Tupelo Mississippi – Sept 2005– [email protected]
Website: neuroimmunedr.com
In progress – facebook site:
SHELBY
EMILY
RYAN
Ryan Now
ADDITIONAL INFORMATION:
Link – Tarzana Hospital Talk – 3/18/09– http://www.tarzanacme.com/video.asp?VidID=
notautism
DVD – Tupelo Mississippi – Sept 2005– [email protected]
Website: neuroimmunedr.com
In progress – facebook site: