1. Unprovoked Seizures in Autistic Individuals
Autism One 2009 Conference
Chicago, IL.
May, 2009
Unprovoked Seizures in Autistic Individuals
Tapan Audhya, PhD
New York University, NY & Vitamin Diagnostics, NJ

2. Seizure (Sudden, Abnormal electrical activity in brain)
Generalized seizure
(Both site of brain)
Unconscious; Both tonic and clonic
Partial seizure (Focal, sensory or petit mal)
(one part of brain; particularly the site which directs “flight” response; conscious; either tonic or clonic)
Simple
(No loss of consciousness)
Complex
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

3. 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

4. Vitamins & Minerals Vitamin B1 in Plasma 32 low, 57 normal
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

5. Protein & Amino Acids Prolactin Glutamate Aspertate Taurine GABA
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

6. Synthesis of GABA and α-Ketoglutarate
Glutamine → Glutamate
Decarboxylase
GABA
P-5-P
Transaminase
α-Ketoglutarate
P-5-P

7. Glutathione Peroxidase
26 low normal
34 less than half the normal value
Free Radical Oxygen
SOD
H202
Glutathione Peroxidase (GP) H GP
GSSG
GSH GR

8. 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” Excitatory
Inform receiving neuron to stop “Firing” 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

9. Impairment of GABA-receptor
GABAergic system in cerebellum and limbic structure in affected in autism. Inhibition of this system is suppressed by
Impairment of GABA-receptor
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

10. GABA Receptor submit Genes in Autism
Chromosome
GABA-receptor
Subunit Gene
4p12
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

11. GABAA Receptor

12. GABAA Receptor

13. 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 mg/day; divided in
3 batches
Vit – B mg/day
Folic Acid 400 mcg/day
Vit – B mcg/day
Vit B 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