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Autism Coach

Autism and Seizure Disorders

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20-40% of individuals within the autism spectrum eventually develop a seizure disorder.  Independently, epilepsy occurs in 1% of the general population. The highest rates of epilepsy within the autism spectrum are among those most severely impaired.  Conversley, 5% of children who develop epilepsy in childhood later receive an autism diagnosis.  Also, there is a correlation between migraines and seizures; an individual with a seizure disorder is more likely to also have migraines. 

Because it is vitally important for individuals and parents of individuals with seizure disorders to be aware of potential seizure triggers, we are providing information for educational purposes. This does not constitute medical advice and is for informational purposes only, please consult with a knowledgeable licensed healthcare professional for medical advice.

Why are individuals within the autism spectrum more at risk for seizures?

There is not a definitive answer from the scientific community yet.  I theorize the increased incidence of seizures partially has to do with a chronic infection in the brain triggering chronic inflammation in the brain.  Chronic inflammation causes the body to be stressed and leads to chronic increased levels of cortisol (the flight or fight hormone). Cortisol causes the body to dump magnesium and zinc from the brain and other parts of the body into muscles to prepare a person to fight or flee quickly. The magnesium and zinc, which are anti-seizure, are then flushed out of the body when the threat is gone.  However, with chronic infection and constantly high levels of cortisol, magnesium and zinc are always at a low level within the brain which greatly reduces the threshold for seizures. Insufficient zinc results in an imbalance in copper/zinc ratio in the frontal lobes of the brain and excessive levels of copper can also be a seizure trigger. This copper/zinc imbalance in the frontal lobes I theorize also impairs higher level thinking and impulse control - leading to more impulsive ADHD type behavior. I theorize that one of the reason Carnosine is anti-seizure and neuroprotective for the majority of people is because it chelates out copper.

I also theorize that, many individuals within the autism spectrum have a neurotransmitter imbalance, where they have far greater levels of neurotransmitters that excite neurons and fewer calming neurotransmitters.  Research indicates many individuals within the spectrum have excessive levels of glutamates, which in an excessive level, can act as an excitotoxin. I theorize this partially arises from skewed metabolic processes triggered by chronic inflammation and overgrowths of toxins in the intestinal tract which cross the blood-brain barrier including ammonia and proprionic acid, which when in excess interfere with neurological metabolic processes and also cause oxidative stress so neurons are more vulnerable to damage and normal ceullar detoxification processes are impaired. This results in individuals within the autism spectrum being more vulnerable to having seizures triggered by excito-toxins, including MSG and aspartame.

Conventional recommendations

This information in this section was reprinted from Autism Speaks. 

At present the treatment of epilepsy in children with autism is based on the same principles as treatment of epilepsy in any child. Should parents suspect that their child is suffering seizures, the first step is to work with a pediatric neurologist to obtain a brain study called an electroencephalogram (EEG), which can determine if these events are indeed seizures. Treatment usually involves an antiepileptic drugs, which the treating physician chooses based on the type of seizure and the associated EEG patterns—to both maximize effectiveness and minimize side effects. By themselves, anti-epileptic drugs fail to resolve seizures in around a third of patients. Such difficult-to-control cases sometimes respond to a ketogenic diet (high-fat, adequate-protein, low-carbohydrate).

Autism Coach comment: Coconut oil, which is high in medium chain triglyceride fats that are intrinsic to the ketogenic diet, is extremely helpful for the majority of individuals within the autism spectrum. The ketogenic diet, the SCD diet, the Feingold diet and the GFCF diet all have helped many individuals within the autism spectrum, either when used separately or in combination.

What are the most common seizure triggers?

Some of the most common triggers are:

  • Excitotoxins - MSG (monosodium glutamate) and Aspartame (containing aspartic acid and formaldehyte) are at the top of the list for food ingredients triggering seizures. Excessive levels of glutamates are common in autism and overcite neurons. Research has shown Aspartame to be a known neurotoxin. Even inhaling aspartic acid (which acts as a hormone) can be problematic, hormones are potent in minute amounts, so it is best to keep diet pop out of the homes of individuals suffering from seizures. Monosodium glutamate is also known as MSG, Gelatin, Calcium Caseinate, Hydrolyzed Vegetable Protein, Textured Protein, Monopotassium glutamate, Hydrolyzed Plant Protein, Yeast Extract, Glutamate, Autolyzed Plant Protein Yeast, Glutamic Acid, Sodium Caseinate, Autolyzed Yeast. Most fast foods have excitotoxins in them so avoid eating at fast food places (this includes french fries) and eating convenience food found at gas stations. This junk food is designed to be addictive and specifically uses excitoxins to excite the taste buds and trigger food addictive tendencies. Aspartame is also known as as Nutrasweet, Equal, Spoonful, Benevia, Natrataste, etc.
  • Food allergies - Food allergies exacerbate inflammatory responses which may also trigger seizures in individuals who also have migraine headaches, hyperactive behavior and abdominal pains. Keep a food diary notes foods eaten, behavior and incidence seizures to eliminate problematic foods.
  • Foods - Grapefruit may interfere with some anti-seizure medications.
  • Vitamins - Folic acid and/or folate, forms of a B vitamin found in most multi-vitamin mineral supplements, can interfere with specific anti-seizure medications.  Also B6 can interfere with specific the effectiveness of specific anti-seizure medications.  Folate and B6, conversely, also have research studies indicating they are strongly anti-seizure.  Each person is unique genetically and biochemically so it is best to consult with a knowledgeable healthcare practitioner to determine which vitamins are best suited for an individual.  Also prescription drugs can interact with other prescription drugs or with natural supplement ingredients to lower seizure threshold - so once again, it is best to consult with a knowledgeable healthcare practitioner.
  • Intestinal overgrowths of toxic organisms - Maldigestion of food and insufficient digestive enzymes leads to of yeast and and pathogenic organisms in the intestinal tract that churn out toxins including ammonia and proprionic acid. These toxins pass through the blood brain barrier and cause neurological damage and lead to neurons being vulnerable to being over-excited, triggering seizures. Probiotics and a diet that is low in sugar and refined carbohydrates and high in fresh vegetables can also help reduce intestinal populations seizure-inducing pathogens.
  • Caffeine - can be in coffee, tea, cocoa, chocolate, most soft drinks, aspirin, etc. Check the labelling. Labels that read "decaffeinated" are not totally free of caffeine. To be sure, the label should read "No caffeine," "Caffeine Free," or indicate that the substance never contained caffeine at all. Much like nicotine, caffeine stimulates the nervous system. Adrenaline is released and the liver begins to emit stored blood sugar. Insulin is then released, and blood sugar drops below normal—a common seizure trigger. And caffeine can be a “stealth” drug, too. It can be found as an ingredient in medications, including some antihistamines and decongestants.Theobromine is very similar to caffeine, and is often a metabolite of caffeine. It is prevalent in tea and chocolate.
  • Man-made pollutants - Estrogenic plastics such as Bisphenol A can be a trigger. Avoid genetically modified foods which frequently have residues of Roundup, which disrupts metabolic processes in the body, including reducing levels of critical natural anti-seizure vitamins such as B12. Also drink purified water as trace levels of seizure-inducing prescription drugs frequently contaminate city water supplies.
  • Theophylline - an asthma drug that is very similar to theobromine.
  • Estrogen - a hormone produced in abundance by women but less so in men. Estrogen can be in meats, dairy products, and other foods. It is always in birth control pills. For women: If you have more seizures around your period, this is an indication that your hormones are out of balance. Talk about this with your epilepsy specialist. Some extra progesterone might help.
  • Soy - can cause problems very much like estrogen due to the phytoestrogens it holds. It is prevalent in tofu, soy sauce, soy beans, edamame, miso, natto, shoyu, tamari, tempeh, texturized vegetable protein, TVP, soy milk, soy nuts, soy grits, soy protein, soy protein isolate, soybean paste / curd, sobe, kyodofu, soy sprouts, soy flour.
  • Stressors/anxiety - can trigger hyperventilation which can provoke seizures, especially absence seizures. It can increase levels of cortisol, excessive levels of which may be a trigger for seizures. The limbic system, the portion of the brain that regulates emotion, is one of the most common places for seizures to begin.
  • Lack of Sleep - Inadequate or fragmented sleep can set off seizures in lots of people. In one study, the lowest risk for seizures was during REM sleep (when dreams occur). The highest risk was during light non-REM stages of sleep.
  • Flickering or flashing lights - If you have photosensitive epilepsy, certain types of flickering or flashing light may incite a seizure. The trigger could be exposure to television screens due to the flicker or rolling images, computer monitors, certain video games or TV broadcasts containing rapid flashes, even alternating patterns of different colors, in addition to intense strobe lights. And surprisingly, seizures may be triggered by natural light, such as sunlight, especially when shimmering off water, even sun flickering through trees or through the slats of Venetian blinds.
  • Illness - High fevers in children can commonly incite a seizure. Vomiting, diarrhea, and fever are all triggers. And vomiting may reduce the dosage level of previously ingested anti-seizure medication. As for adults, they usually weather illness fine but it can reduce the seizure threshold, and make you more likely to have a seizure.
  • Prescription drugs - Some prescription medications — especially penicillin, anti-depressants and anti-anxiety drugs — can prevent anti-seizure medication from working. Make sure all your doctors know everything you or your child takes.
  • Alcohol - There are two questions that have to be considered when the question of alcohol use and epilepsy comes up. One is the effect that alcohol could have on the medicines used to control seizures. Alcohol can be dangerous when mixed with sedative drugs and can cause coma, or even death. The other question is whether the alcohol itself will cause seizures. Large amounts of alcohol are thought to raise the risk of seizures and may even cause them. When you drink alcohol, it may temporarily reduce seizures for a few hours, but then increases the chances of a seizure as the alcohol leaves your body.
  • Cigarette smoking - Nicotine is both a stimulant and a depressant to the central nervous system. The nicotine in cigarettes acts on receptors for the excitatory neurotransmitter acetylcholine in the brain, which increases neuronal firing. But if you want to STOP smoking, here’s a piece of scary information: some nicotine preparations used to help people stop smoking can have a side effect of convulsions. So, if you’re thinking of quitting, check out your smoking cessation program with your doc first.
  • Individual Triggers - A common trigger is too much heat, internal from extremely excessive exercise or external from an overheated house or apartment. Other triggers include the smell of glue and the color yellow! Many people have their own specific triggers, while others don’t.

Natural ingredients that may reduce incidence of seizures

To reiterate, this does not constitute medical advice and is for informational purposes only. If you or your child are diagnosed with a seizure disorder, please consult with a knowledgeable healthcare professional. Genetic testing of the MTHFR gene may be recommended to determine which vitamins, their forms and ratios are most likely to benefit an individual. Generally, the nutritional ingredients that are helpful directly or indirectly contribute to the manufacture of calming neurotransmitters and support detoxification and methylation processes. If you or your child are already on an anti-seizure med, please read our section below on natural ingredients that may interfere with anti-seizure meds. Remember that everyone is unique genetically and biochemically and will respond uniquely to diet, supplements, and prescription drugs - there is no one size fits all - and it is best to consult with a licensed health care practitioner for recommendations.

Individuals with seizure disorders tend to be low in the following vitamins and minerals:

  • Magnesium
  • Zinc - levels of zinc tend to be low.
  • Vitamin D - Vitamin D3 appears to be one of the better forms of this vitamin
  • Folic Acid/folate - Usually low in individuals with autism and seizure disorders.  For most individuals it is strongly anti-seizure but it can also interfere with the effectiveness of specific anti-seizure medications so if on antii-seizure meds, consult with a licensed knowledgeable medical practitioner.
  • B6 - For most individuals, it is strongly anti-seizure, but it can also interfere with the effectiveness of specific anti-seizure medications, so if on anti-seizure meds, consult with a licensed knowledgeable medical practitioner.  Generally the active form of B6, P5P, is better absorbed.
  • B12 - generally the active form, methylcobalamin, is best absorbed, but it is best to consult with a knowledgeable healthcare practitioner.
  • B3 - niacin; generally anti-seizure; but may reduce effective of some anti-seizure medications, lowering seizure threshold
  • B5 - panthothenic acid
  • B8 - inositol
  • Choline - works with inositol and is in the B vitamin family

Other supplements that may be helpful include:

  • Carnosine - a double blind study shows carnosine to be beneficial for children diagnosed with both autism and seizure disorders.
  • Calming neurotransmitters - GABA, Melatonin. The body regulates the levels of neurotransmitters, and if a neurotransmitter such as GABA or Melatonin is given daily, the body may stop naturally producing it. It is often recommended that calming neurotransmitters be given approximately every 3 days.
  • Probiotics - reduce levels intestinal pathogens that produce seizure-inducing toxins that pass through the blood brain barrier
  • Taurine
  • Glycine - also in form of dimethylglycine (DMG) and trimethylglycine (TMG)
  • Ornithine
  • Lysine
  • Alpha-Lipoic Acid
  • Glutathione
  • N-Acetyl-Cysteine
  • Milk Thistle
  • Ashwaghanda
  • Rhodiola Rosea
  • Yucca Root

If you or your child are already on an anti-seizure medication

The following is tables of information I have sourced from the internet concerning prescription drugs and supplements that may interfere with anti-seizure medications.

Prescription drugs that can provoke seizures

The following prescription drugs can lower the seizure threshold, increasing risk of seizures. This is provided for informational purposes and does not constitute medical advice.

Anesthetics

  • Enflurane

Antibiotics

  • acyclovir/Zovirax
  • amphotericin B/Amphotec
  • cefepime/Maxipime
  • cefixime/Suprax
  • cefotetan/Cefotan
  • ceftazidime/Fortaz, Tazidime
  • cefuroxime/Zinacef
  • cephalexin/Keflex
  • chloroquine/Aralen
  • cilastatin/imipenem Primaxin
  • ciprofloxacin/Cipro
  • dexmethylphenidate/Focalin
  • doripenem/Doribax
  • efavirenz/Sustiva
  • ganciclovir/Cytovene
  • gemifloxacin/Factive
  • imipenim/Cilastatin
  • Isoniazid/ (INH) Nydrazid
  • ivermectin/Stromectol
  • levofloxacin/Levaquin
  • lindane/Agrocide
  • linezolid/Zyvox
  • lomefloxacin Maxaquin
  • mefloquin/Larium
  • meropenem/Merrem
  • metronidazole/Flagyl
  • moxifloxacin/Avelox
  • nalidixic acid/Negram
  • ofloxacin/Floxin
  • tinidazole/Tindamax
  • valacyclovir/Valtrex
  • zanamivir/Relenza
  • zidovudine/Retrovir capsules

Antihistamines

  • diphenhydramine/Benadryl - in withdrawal
  • hydroxyzine Atarax, Vistaril - in withdrawal
  • trihexyphenidyl/Artane

Attention Deficit Disorder

  • atomexietine Strattera
  • dextroamphetamine/Dexedrine
  • methylphenidate/Ritalin, Concerta

Bladder

  • oxybutynin/Ditropan
  • tolterodine/Detrol-LA

Blood treatment

  • epoetin/Epogen
  • ticlopidine/Ticlid
  • captopril/Capoten
  • carvedilol/Coreg

Blood Pressure

  • torsemide/Demadex
  • valsartan/Diovan

Cancer

  • busulfan/Myleran
  • chlorambucil/Leukeran
  • cisplatinum/Cisplatin
  • cyclophosphamide/Cytoxan
  • doxorubicin/Doxorubicin
  • etoposide/Vepesid
  • methotrexate/Trexal
  • temozolomide/Temodar
  • thalidomide/Thalomid
  • vincristine/Oncovin

Cholesterol

  • atorvastatin/Lipitor
  • fluvastatin/Lescol XL

Dementia

  • donepezil/Aricept
  • memantine/Namenda
  • rivastigmine/Exelon
  • tacrine/Cognex

Gastrointestinal

  • dicyclomine/Bentyl
  • dronabinol/Marinol
  • ondansetron/Zofran
  • promethazine/Phenergan

Headache

  • almotriptan/Axert
  • Headache sumatriptan/Imitrex
  • Headaches caffeine/Cafcit

Hormone

  • estrogen/Premarin

Immune

  • cyclosporin/Gengraf, Sandimmune
  • mycophenolate/CellCept
  • prednisone/Deltasone
  • tacrolimus/Prograf

Multiple sclerosis

  • 4-aminopyridine/Fampridine
  • azathioprine/Imuran
  • glatiramer/Copaxone
  • inteferon beta-1a/Avonex, Rebif
  • inteferon beta-1b/Betaseron
  • mitoxantrone/Novantrone
  • baclofen/Liorisal - in withdrawal

Muscle relaxant

  • carisoprodol/Soma In withdrawal
  • cyclobenzaprine/Amrix
  • cyclobenzaprine/Flexeril, Amrix
  • dantrolene/Dantrium
  • methocarbamol/Robaxin
  • tizanidine/Zanaflex

Obstetric

  • clomiphene/Clomid
  • oxytocin/Pitocin

Pain

  • bupivicaine/Marcaine
  • fentanyl/Duragesic, Actiq
  • indomethacin/Indocin
  • ketorolac/Toradol
  • lidocaine/Marcaine
  • mefenamic acid/Ponstel
  • meperidine/Demerol High doses
  • oxycodone/Percocet, Percodan
  • oxymorphone/Opana
  • pentazocine/Talwin
  • procaine/Novocain
  • propoxyphene/Darvon
  • tramadol/Ultram
  • ziconotide/Prialt

Parkinson’s Disease

  • benztropine/Cogentin
  • bromocriptine/Parlodel
  • cabergoline/Dostinex
  • entacapone/Comtan
  • pramipexole/Mirapex
  • rasagiline/Azilect
  • ropinerole/Requip
  • selegiline/Eldeprel
  • tolcapone/Tasmar

Psychiatric

  • alprazolam/Xanax In withdrawal
  • amitriptyline/Elavil
  • amoxapine/Moxadil
  • aripiprazole/Abilify
  • bupropion/Wellbutrin > 300 mg
  • buspirone/BuSpar
  • chlorpromazine/Thorazine
  • citalopram/Celexa
  • clomipramine/Anafranil
  • clonazepam/Klonopin- in withdrawal
  • clorazepate/Tranxene- in withdrawal
  • clozapine/Clozaril, Fazaclo
  • desipramine/Norpramin
  • diazepam/Valium- in withdrawal
  • doxepin/Sinequan - in withdrawal
  • duloxetine/Cymbalta
  • escitalopram - Lexapro
  • fluoxetine/Prozac
  • fluphenazine/Prolixin
  • Psychiatric haloperidol Haldol
  • lithium/Lithobid
  • lorazepam/Ativan - in withdrawal
  • loxapine - Loxitane
  • mirazapine - Remeron
  • molindone - Moban
  • nortriptyline - Pamelor
  • olanzapine - Zyprexa
  • paroxetine - Paxil
  • pimozide - Orap
  • protriptyline/Vivactil
  • quietapine/Seroquel
  • risperidone/Risperdal
  • sertraline/Zoloft
  • thioridazine/Mellaril
  • thiothixene/Navane
  • tranylcypromine/Parnate
  • trifluperazine/Stelazine
  • venlafaxine/Effexor
  • ziprasidone/Geodon

Recreational

  • l alcohol many - in withdrawal
  • amphetamines - Dexedrine, Adderal
  • cocaine
  • sildenafil/Viagra
  • tadalafil/Cialis
  • vardenafil/Levitra

Respiratory

  • aminophylline/Truphylline
  • montelukast/Singulair
  • terbutaline/Terbutaline
  • theophylline/Uniphyl

Seizures

  • mephobarbital/Mebaral - in withdrawal
  • phenobarbital/Luminal - in withdrawal
  • primidone/Mysoline - in withdrawal

Skin

  • isotretinoin/Accutane

Sleep

  • estazolam/ProSom - in withdrawal
  • eszopiclone/Lunesta- in withdrawal
  • flurazepam/Dalmane - in withdrawal
  • modafinil/Provigil - in withdrawal
  • rameltron/Rozerem - in withdrawal
  • sodium oxydate/Xyrem
  • temazepam/Restoril - in withdrawal
  • triazolam/Halcion - in withdrawal
  • zaleplon/ Sonata - in withdrawal
  • zolpidem/Ambien - in withdrawal

Weight Loss

  • sibutramine/Meridia

Natural ingredients that can provoke seizures or reduce effectiveness of anti-seizure prescription drugs

The tables below are provide for educational purposes only and does not constitute medical advice. Please consult with a licensed, knowledgeable healthcare practitioner concerning for information on seizure medications.

Links

http://epilepsytalk.com/2011/09/19/weird-epilepsy-...

http://www.learnaboutepilepsy.com/pdfs/herbal_chart.pdf

http://www.wikihow.com/Avoid-Food-Triggered-Seizures

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