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Acquired reversible autistic syndrome in acute encephalopathic illness in children
Insights
This study presents three children who developed reversible autistic syndrome during an acute illness, suggesting a link to medial temporal lobe disease. This acquired condition highlights potential neurological underpinnings of childhood autism.
Area of Science:
- Neurology
- Developmental Psychology
- Pediatrics
Background:
- Previous research suggested medial temporal lobe or mesolimbic cortex involvement in childhood autism.
- Understanding the neurological basis of autistic syndromes is crucial for diagnosis and treatment.
Observation:
- Three children developed symptoms consistent with infantile autism during an acute encephalopathic illness.
- One child showed elevated herpes simplex virus titers and temporal lobe lesions on CT scan.
- The autistic syndrome was reversible and distinct from acquired epileptic aphasia.
Findings:
- The cases demonstrate an acquired and reversible autistic syndrome in childhood.
- Clinical similarities were noted to bilateral medial temporal lobe disease and the Klüver-Bucy syndrome.
- Etiology was identified in one case (herpes simplex virus) but remained undefined in others.
Implications:
- These findings suggest that acute medial temporal lobe insults can lead to reversible autistic syndromes.
- Highlights the importance of considering acquired neurological conditions in the differential diagnosis of childhood autism.
- Further research into the neurobiological mechanisms of autism and its potential reversibility is warranted.
Abstract:
In seeking the neurologic substrate of the autistic syndrome of childhood, previous studies have implicated the medial temporal lobe or the ring of mesolimbic cortex located in the mesial frontal and temporal lobes. During an acute encephalopathic illness, a clinical picture developed in three children that was consistent with infantile autism. This development was reversible. It was differentiated from acquired epileptic aphasia, and the language disorder was differentiated aphasia. One child has rises in serum herpes simplex titers, and a computerized tomographic (CT) scan revealed an extensive lesion of the temporal lobes, predominantly on the left. The other two, with similar clinical syndromes, had normal CT scans, and no etiologic agent was defined. These cases are examples of an acquired and reversible autistic syndrome in childhood, emphasizing the clinical similarities to bilateral medial temporal lobe disease as described in man, including the Klüver-Bucy syndrome seen in postencephalitic as well as postsurgical states.