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USAAA 071009 final
- 1. 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 318 TARZANA, CALIFORNIA 91356 TELEPHONE (818) 343 – 1010 www.neuroimmunedr.com
- 2. 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”
- 3. 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
- 4. BODY SYSTEMS: ♦Endocrine ♦Immune ♦Hematology ♦EENT ♦Cardiovascular ♦Pulmonary ♦GI ♦GU ♦Muscular - Skeletal ♦Neuro
- 5. DISEASE MECHANISMS: ♦Metabolic – Toxic ♦Genetic –Developmental ♦Tumor - Trauma – Insult ♦Psychogenic?? ♦Infectious ♦Immunologic
- 6. 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
- 7. 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
- 8. 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
- 9. “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. . .
- 10. 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.
- 11. IMMUNE SYSTEM – ACTIVATED / SUPPRESSED vs. DYSFUNCTIONAL
- 12. “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)
- 13. “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
- 14. 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
- 16. Neuroglial Activation and Neuroinflammation in the Brain of Patients with Autism Diana L. Vargas, MD, Caterina Nascimbene, MD,1Chitra Krishnan, MHS1 Andrew 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
- 17. 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.
- 18. IT’S A COMBINATION OF STRESSES – NOT ONE FACTOR
- 19. Alzheimer’s Anxiety Adult ADHD Fatigue Schizophrenia ADHD’S Depression LD’S Panic Attacks Asperger Autism CFS Bipolar The “Real” Bell Curve Epilepsy - Seizures NEUR0-IMMUNE Related Disorders
- 20. 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
- 21. 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
- 22. 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
- 23. 10 YR. OLD FEMALE EPILEPSY - ? AUTISM ♦ NK cells 2.8% ♦ sed rate 1
- 24. CHILD – DOING WELL/“NORMALIZING”
- 25. DOING OK – “BUT NOT GOOD ENOUGH”
- 26. CHILD – DOING POORLY:
- 27. DAN Protocol - CHELATION:
- 28. DAN – IV GLUTAHIONE, HBOT, CHELATION - SEIZURES
- 29. Implication: Potential For Recovery Autism / 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
- 30. “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
- 31. GRADE DISTRIBUTION SHIFTS “UP THE SCALE” FROM INITIAL TO FINAL GRADE NUMBER Dat a Frequency 12108642 25 20 15 10 5 0 9.035 1.845 100 5.551 2.148 99 Mean StDev N Initial NUMBER Final NUMBER Variable Histogram of I nitial NUMBER, Final NUMBER Normal Lower GRADE Number (a shift to the LEFT) indicates improvement Scale A+ 1 A 2 A- 3 B+ 4 B 5 B- 6 C+ 7 C 8 C- 9 D+ 10 D 11 D- 12 A B C D
- 32. ADDITIONAL INFORMATION: ♦ Link – Tarzana Hospital Talk – 3/18/09 – http://www.tarzanacme.com/video.asp?VidID= notautism ♦ DVD – Tupelo Mississippi – Sept 2005 – kmatthews@regionalrehabcenter.com ♦ Website: neuroimmunedr.com ♦ In progress – facebook site:
- 33. SHELBY
- 34. EMILY
- 35. RYAN
- 36. Ryan Now
- 37. ADDITIONAL INFORMATION: ♦ Link – Tarzana Hospital Talk – 3/18/09 – http://www.tarzanacme.com/video.asp?VidID= notautism ♦ DVD – Tupelo Mississippi – Sept 2005 – kmatthews@regionalrehabcenter.com ♦ Website: neuroimmunedr.com ♦ In progress – facebook site: