FBPixel Autism Case - David Perlmutter M.D.

Autism Case

Jason is a 10-year-old who was brought to see me by his mother because he was “on the spectrum.” While there were no overt complications with his actual birth, mother reported that during the course of her pregnancy, and in fact during her entire third trimester, she was on daily antibiotics because of  “persistent bladder infections.”

Indeed, shortly following Jason’s birth, he also began taking multiple courses of antibiotics because of  “persistent ear infections.” And in fact mother indicated that during his first year of life he was on antibiotics “more often than not.” She also reported that during his first month he was “crying all the time.”

Because ear infections were so pervasive during his early life he ultimately had  “ear tubes” placed, And in fact this procedure had to be repeated on two occasions. Thereafter he continued to receive antibiotics at least every year because of “strep throat” multiple times with a severe event occurring at age 4 years. Mother reported that at times antibiotics had actually been ”given by injection.”

Interestingly, but not surprisingly, at age 2 years he became profoundly ill with diarrhea with one physician actually diagnosing him as having celiac disease initially, but ultimately this was not confirmed.

Around 13 to 14 months, Jason’s parents became suspicious of development issues, and began at that time occupational as well as physical therapy. Jason had a profound delay in his ability to speak but he was my age 3 years able to use sign language while only speaking single words.

As you would expect, his parents had taken him to multiple doctors and his work up had been extensive, including EEG monitoring, MRI scans of the brain, a variety of blood studies, all of which were unrevealing.

His mother reported that he had developed significant obsessions with things like turning lights on and off, as well as very repetitive hand movements. He had significant socialization skills and would not interact with others to any significant degree. She told me that he became very anxious and uncomfortable when he was in any environment that was unsteady or would challenge his balance.

With respect to his appetite, mother indicated that his appetite was actually quite good but that he was extremely “picky” with reference to the foods he would choose to eat.

Before I examined Jason I was provided with a compendium of his previous medical records which basically confirmed what his mother had described. What was interesting was that there were multiple entries by his treating physicians over the years not just for throat infections and ear infections requiring antibiotics, but multiple entries for gastrointestinal issues as well indicating “stomach ache,” for example as the reason for the office visit. In fact, he had seen a doctor at one point because of  “projectile vomiting.”

When I examined Jason I found that his neurological examination was in fact intact. He showed good coordination, good balance, and a normal ability to walk and run. During the course of his examination he did appear somewhat anxious and when he became anxious he began ringing his hands in a very stereotypic way. He could not remain in a seated position for any meaningful length of time and there was obviously significant loss of eye contact with me as I examined him. He couldn’t really construct a meaningful sentence when he attempted to speak.

After completing my examination and reviewing Jason’s medical records I sat down with his mother and discussed my findings and recommendations. I indicated that in fact, his history as well as examination were quite consistent with autism and beyond that, I spent a lot of time describing to his mother how extensive were his exposures antibiotics, Not just prior to birth, but subsequently, as she well understood. I described the role of the gut bacteria in terms of modulating inflammation and regulating brain function as well as how recent research had clearly revealed a correlation between significant changes in the type of bacteria in the gut and autism, all the while paving the way for what was to come in terms of my upcoming recommendations.

At that point, I felt clearly Jason’s mother would easily embrace the notion of using probiotics along with some vitamin D and adding in some good prebiotics foods. That was the easy part.

I anticipated surprise or even rejection when I went so far as to propose fecal transplantation for Jason. As a matter of fact, Melinda, his mother, was actually very open to the idea and said to me that she and her husband had tried everything else and nothing had worked. At that point, she revealed how she had come to bring her child to me. She had been in a parking lot, and parked her car next to a truck upon which the words “Home handyman can fix anything” had been painted. Apparently, the home handyman perceived that there were issues with Jason as his mother was taking him out of the car. And, from what I am told, at that point he told Jason’s mother to bring him down to Florida, to our clinic.

I didn’t feel it was necessary to perform a lot of laboratory studies, but one thing that I have found helpful is to perform a stool analysis to get a sense as to the health of the gut. This study was quite revealing as a demonstrated absolute absence of lactobacillus species, an indication of significant trauma to the gut bacteria.

My first follow up with Melinda was three weeks later. At this point Jason had begun aggressive probiotics, and vitamin D, and she reported that his anxiety seemed significantly improved and he was able to tie his own shoes for the very first time. Incredibly, he was actually able to ride a roller coaster and, also for the first time, and was able to spend the night away from home.

Five weeks later Melinda reported that his improvements had persisted but he have not made any other gains. She stated that she was quite interested in pursuing fecal transplantation as she had studied it and felt, based upon what she had read, that it could prove helpful. She had identified a donor, the daughter of a friend, 14-year-old girl who had been quite healthy all of her life, and she had decided to move ahead with performing this procedure on her own, at home.

As I spoke with Melinda from time to time on the telephone I realized that nothing would hold her back. She had learned everything she could about fecal transplantation and actually had begun this procedure with Jason.

My next contact with her came in the form of the video that was sent to my cell phone actually at a time when I was lecturing in Germany. This brief video clip took my breath away and brought tears to my eyes.  It showed Jason jumping up and down on a trampoline speaking quite fluently with his mother and appearing happy as the day is long. There was no text accompanying this video nor did there need to be.

When I returned from Germany, I spoke with Melinda. She indicated that she had completed six fecal transplants and when I asked her how Jason was doing, She reported the following:

“He is so much more talkative and conversational and in fact he now initiates conversation himself. There is no more handwringing and he doesn’t talk to himself anymore. He is so calm and interactive. The other day he sat in a chair for 40 minutes talking to me while I was getting my hair done. I’ve never seen him do this. We do not have to tell them what to do anymore around the house, like clean up and vacuum his room, and put things away. And we’ve gotten the report from his teacher saying that Jason is now ‘present’ and very conversational. For the first time ever he’s singing hymns in church and we feel very blessed by this. He will eat almost anything and is now excited to try new foods. Thank you for healing my son.”

Medical science has made some incredible advances related to autism. Problems with the gut for years have been looked upon as simply another set of symptoms, but we now recognize that it may very well be that issues with the gut may well be front and center in terms of causing this disease as scientific literature is certainly confirming. I don’t want to be perceived as offering up the notion of fecal transplantation as representing a “cure” for autism but I can certainly tell you that from a scientific perspective it makes absolute sense and from our clinical experience, it is working.

Jason’s response to this procedure was very healing for both himself and his family. The videotape that Melinda sent me well-characterized the paradigm shift in our ability to treat autism. My conversations with Jason’s mother now have centered upon what more can be done so that others can learn about this new perspective on treating autism. As such, she has agreed first that I could write about his case not only in this book but here on my website as well. She has allowed me to share this video.

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