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Here is my situation. My son is 4 and autistic. He has

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always displayed self injurious behaviors...
Here is my situation. My son is 4 and autistic. He has always displayed self injurious behaviors which have been highly elevated in the last month. There has been severe punching of himself in the face and head, and most recently, his chin. When his hands are restrained to prevent from hitting, he manages to knee himself extremely hard in the face, nose, mouth, etc. My question is this. Could this behavior be symptomatic of seizures? If so, what would the best course of action be (please understand our local neurology department, even with referrals from numerous doctors, refuse to see him because there has been no diagnosis of headaches or seizures)? In order to treat this, if in fact these are seizures that he is experiencing, could a medically induced coma be recommended? If that is necessary, what is the chance of good outcome?
Submitted: 4 years ago.Category: Neurology
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Answered in 8 hours by:
3/17/2013
Neurologist: healthydoc, Board Certified Physician replied 4 years ago
healthydoc
healthydoc, Board Certified Physician
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Satisfied Customers: 1,986
Experience: Board Certified U.S. Neurologist
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healthydoc :

Hello and thank you for your question.

healthydoc :

Aggressive behavior is common in children with autism. There are several forms of aggression. Physical aggression can cause an autistic child to hurt himself and others when directed at inanimate objects. Autistic children also can engage in verbal aggression that includes insults and yelling.

healthydoc :

When an autistic child becomes aggressive, staying calm and talking quietly while refraining from saying anything inflammatory. When faced with this situation, caretakers should remove objects that could prove dangerous, and ask that others leave the room so that the autistic person is in a one-on-one situation with a trusted individual. These efforts should help quiet down an aggressive child and soothe the aggression temporarily.

healthydoc :

behavioral therapy works to teach appropriate social behaviors in the belief that it will help stem aggressive behavior. Behavioral interventions can include applied behavior analysis, in which good behavior gets rewarded and poor behavior ignored; sensory integration therapy, in which autistic patients slowly build up tolerance for stimulation that triggers aggression; and play therapy to teach improved social skills in a controlled setting.

healthydoc :

Along with the behavior therapy medications can also help to ease the behavior. Medications like Serequel can help to calm his behavior as study suggest anti psychotic drug can reduce these type pf behavior by 70%.

healthydoc :

It is not likely to be a seizure activity as if he had seizures he would have other symptoms like muscle jerking, lip smacking and would feel lethargic.

healthydoc :

Please get back to me if you have any further questions. Thank you.

Customer:

Understood. However, tomorrow we have an appointment with his developmental pediatrician who may recommended a possible hospitalization. Now when he was a year and a half (pre-diagnosis) he was admitted for a day due to extreme constipation (which was due to his autism, unknown at the time). When the doctors were trying to run tests and get x-rays and such done he needed to be sedated to a very dangerous level (the doctors later told us that they were uncomfortable in pushing it that far) and still required 5 people to hold him down. Could there be a need for this in this situation if hospitalization is required? What tests should we get done? Any info you have or even a point in the right direction would be thoroughly appreciated.

healthydoc :

There are certain diseases where self-injurious behavior is commonly seen. Autism is one of those conditions. To some degree children with autism feel disconnected from their world and are not able to sense things. This lack of feeling often triggers behaviors which lead to self injury as it is something that gives them sensory input. Self-injury also helps them feel more grounded in their surroundings.

healthydoc :

This behavior is clearly harmful as such helping your son find an alternative means of sensing his environment may be the best therapy of all. This takes time and training with a good therapist who are trained at working with autistic children. I'm quite sure that this behavior does not represent seizure activity as it is goal directed. Seizure activity is not goal directed activity.

healthydoc :

Some psychologists state that the self-injury is a form of relieving anxiety. Regardless of its reason this behavior needs treatment with anti psychotic meications.

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