Tuesday, 11 May 2010
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Seizures and PDD - The Basics
From: Dr. Chun Wong
Seizures are something we associate with Epilepsy. — a brain disorder in which multiple, unexpected seizures are triggered. Seizures are also a very common symptom of Pervasive Development Disorders (PDD) including Autism.
The Basics - What Is a Seizure?Seizures themselves are highly studied. Seizures occur when there is abnormal electrical activity in the brain. There are times in which the brain’s neurons all fire simultaneously, and this is what causes a seizure to occur. The majority of people think of a seizure as the violent convulsing, unconscious episode that people have. This is true - some seizures, known as tonic clonic seizures are characterized by uncontrollable and violent shaking. This is because both sides of the brain are affected. However, a partial seizure - only affecting part of the brain - can be as mild as losing awareness for a brief amount of time. The recurrence of seizures is known as Epilepsy, however, seizures can occur in people who do not have epilepsy as well.
Because seizures have so many symptoms, and can sometimes affect different parts of the body, they are classified into motor, sensory, autonomic, emotional, or cognitive.
Why Seizures Occur in PDD and Autism CasesIt has been found that one in four children with a PDD will develop seizures. Most recent studies conclude that 1/3 of Autistic children will also develop epilepsy. Though it was heavily documented in the 1960’s when the connection between Autism and Seizures was studied, researches even today are working hard to establish links between seizures and Autism.
Another interesting study is that the chances of developing seizures range based upon which subcategory of PDD that the person has. The present studies suggest that people with classical Autism have a 30% risk of having seizures, while those with Asperger Syndrome have less than a 10% risk. Those with Dis-integrative Disorder or Rett Syndrome have over 75% chance of developing seizures. What this shows us is that there are risk factors - specifically in Autism - that determine the risk of a person who has PDD developing seizures.
The major risk factors for a child with Autism developing seizures is the level of cognitive impairment and motor deficits. The more common symptoms of Autism - clumsiness, fine motor coordination, aren’t as severe as paralysis on one side or forms of cerebral palsy. The more severe the cognitive impairment, in some cases, the greater the risk for developing seizures. In a child with Autism, who has normal intelligence and no other apparent mental condition or family history of seizures, the chance of them developing seizures is less than 10%. However, if the Autistic child has mental retardation or severe motor deficit, the risk rises to 50%
Treating SeizuresSometimes, seizures give a signal of their onset. Some sufferers report a strange taste in their mouths, sudden body temperature change, etc. Sometimes, they are unexpected. Typically, seizures can be controlled with medication. It’s very important that the type of seizure, whether or not its epilepsy, and the underlying cause of the seizures is studied as to provide the appropriate medication.
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Comments (11)
Having stumbled across Mr Wong here at Autisable and on various blogs and forums, I decided it was time to really begin to look at his site. I mean, as a mom to three on the spectrum and a blogger (Countering Age of Autism --where I also counter all manner of woo), how could I leave any stone unturned? Frankly, what I find is more than a bit disturbing and the following is my blog post on what I found, as well as an examination of the Wong's post here on epilepsy and autism.
You gotta give Chun Wong props; he tries hard to rack up business. He posts on forums, he's got a blog on autisable (linked above). He's selling the woo and makes it appealing by appealing to the lowest common denominator. Nothing says offensive like: "If you want your family life back the way it was before Autism stole so many of its precious irreplaceable moments." Well, that's not quite true. This is even more offensive, and such a completely obvious tactic that it really shouldn't work: "Why suffer another day? The answer to your autistic child’s suffering may be here - right in front of you… How would you feel, finding out years from now, that the answer to your child’s pain and suffering was right in front of your face all along…and you let it slip through your fingers?"
Wong characterizes himself as a "doctor" and a "practicing physician" According to Wong, he practices "medicine in Illinois and specialize in chronic pain and pediatric conditions, including autism." Funny, the state of Illinois doesn't have a Chun Wong licensed to practice medicine. Must be a newfangled definition of medicine, not misrepresentation, right? I mean, who would think that when you say you're a doctor and a physician, you really don't mean a medical doctor and practicing medicine is in no way suggestive that you actually practice, you know, medicine.
Wong writes that because he is super busy as a DAN! doc, "my time is limited and I do not provide 24- hour call or emergency services or maintain hospital-admitting privileges." No, he doesn't provide "emergency services or hospital-admitting privileges" because he is NOT a doctor of medicine.
He sells a manual to heal your child, but I guess I'm not a candidate: "However, this manual is NOT for every parent. It is not for those who don’t have an open mind or who are negative people. This manual requires you to have optimism, hope and to have an alternative belief system! Get my manual NOW to learn more about autism and all of the autism spectrum disorders and to attract more joy and health into your child’s life." Hahaha, yeah, see, if it doesn't work, and it won't, it'll be the parents' fault. So how much will it cost you to recover your child? Well, if you're not negative like me, then for $299 you can get his book, a phone consult with him, and two coupons so you can ask him for help. Let me tell you, I'm finding it really, really hard to feel compassionate for suckers who get roped into woo this obvious.
Wong's just trying to help, though, and Autisable really likes him because, man, the hits keep coming when they put some Wong woo up on their front page. In 45 posts with them, he's had over 26,000 hits. You can't blame Autisable for putting his stuff there, I guess. And sometimes, it's fairly innocuous stuff that doesn't seem designed to sell his woo. Of course, by getting his face out there and the link to his site there, he's getting visibility, and you know the power of networking, right?
So what's his latest post about? Epilepsy and autism, or as he calls it: "Seizures and PDD - The Basics." There's no real meat to it, though, and no sources, just empty promises: "Why Seizures Occur in PDD and Autism Cases." Except Wong isn't going to address that, just reference vague studies and throw numbers out at you: "It has been found that one in four children with a PDD will develop seizures. Most recent studies conclude that 1/3 of Autistic children will also develop epilepsy."
The figure of about 1/3 of individuals with autism also having epilepsy is the generally accepted number, but there is variation in the prevalence of epilepsy in autistic individuals. Citing Rossi et al. (1995), Tuchman and Rapin (2002), and Danielsson et al.(2005), Levisohn (2007) notes that the "prevalence of epilepsy in children with autism isvstriking—5–38% of children with autism have comorbid epilepsy" (p. 33).
Chun Wong asserts (with no sources, so no way to assess his accuracy): "In a child with Autism, who has normal intelligence and no other apparent mental condition or family history of seizures, the chance of them developing seizures is less than 10%. However, if the Autistic child has mental retardation or severe motor deficit, the risk rises to 50%."
Okay, so not too far off as it relates to the individuals who don't have accompanying ID: Levisohn writes: "In children with autism without mental retardation or cerebral palsy, the risk of epilepsy is low with a cumulative probability of 2% by 5 years and 8% at 10 years. If there is comorbid severe mental retardation, the probability is 7% at 1 year, 16% at 5 years, and 27% at 10 years. In the presence of both mental retardation and cerebral palsy, the risk rises to 20% at 1 year,35% by 5 years, and 67% at 10 years (Tuchmann & Rapin, 2002). Epilepsy persists in the majority of patients into adult life with remission in only 16% of adults with autism and epilepsy (Danielsson et al., 2005)" (p. 34). Maybe he's just hedging it on the 50% number, deciding a ballpark figure is close enough, you know, like saying you're a doctor, letting folks think you mean MD, when what you mean is a woo-meister.
This doesn't tell you why, though, epilepsy and autism are found at greater rates than epilepsy is in the general population ("0.5-2%"). In fact, the whole post is without much substance. How should you treat epilepsy, Wong's closing paragraph?: "It’s very important that the type of seizure, whether or not its epilepsy, and the underlying cause of the seizures is studied as to provide the appropriate medication." Okay, honestly, this doesn't make a lot of sense, but the one thing you can rest assured of is that Wong can't prescribe the medication. Why? Because he is not a doctor.
References
Levisohn, P. (2007). The autism-epilepsy connection. Epilepsia (Series 4), 4833-35. doi:10.1111/j.1528-1167.2007.01399.x.
You do not have a medical degree-thus are NOT a practicing physician. A doctorate does not an M.D. make-nor a physician. What I find so alarming is that you slap together a few pieces of information (of course you don't cite anything-cause you're a physician-you don't have to, right?). In the hopes to get people to your site-where you can sell them "unproven" treatments. Anyone interested can read this blogpost-by a medical doctor about what it takes to get certified as a DAN! practitioner.
http://storkdok-nos.blogspot.com/2008/11/dan-doctors-are-not-autism-experts.html
I will note for the record that Wong is licensed as a chiropractic physician in Illinois. Perhaps, Wong might want to amend his pronouncements that he is a practicing physician and doctor to reflect that he is a practicing chiropractic doctor, though? That way the woo is upfront and center and there is no appearance of intent to deceive.
My son is 37 and has had epilepsy since he was nine. Just to inform you that approximately 30% of people who have epilepsy their seizures cannot be controlled by medication. We are seeking alternative treatment with the B.E.S.T. Technique. It may be something you might want to look into. I have always believed in alternative treatments, but even more so now when the neurologist told me there is nothing he can do for my son.
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