Autism and Focal Seizures Associated with Left Hemispheric Cortical Atrophy: A Novel Clinical Pattern

Advisor Doctor and Expert Trainer, Baghdad Medical City and Iraqi Ministry of Health Baghdad, Iraq

*Corresponding Author: Aamir Jalal Al-Mosawi, Advisor Doctor and Expert Trainer, Baghdad Medical City and Iraqi Ministry of Health Baghdad, Iraq, Email: [email protected]

Received Date: October 16, 2025

Published Date: October 29, 2025

Citation: Al-Mosawi AJ. (2025). Autism and Focal Seizures Associated with Left Hemispheric Cortical Atrophy: A Novel Clinical Pattern. Mathews J Psychiatry Ment Health. 10(2):54.

Copyrights: Al-Mosawi AJ. (2025).

ABSTRACT

Background: Autism disorders are a very complicated and multifarious group of chronic disorders that are characterized by early impairment in social interaction and communication. The diagnosis of autism is clinical and is based on the presence of characteristic diagnostic manifestations resulting from impaired social interaction and communication, which cause the two major diagnostic features of autism: the lack of appropriate responsiveness to one's own name and the lack of eye contact. Poor speech development with difficulties in using and understanding language, and repetitive body movements including hand flapping, and spinning, or behavior patterns are important associated features of autism disorders. Autism disorder is a heterogeneous group of disorders that are typically considered a functional neurodevelopmental disorder without consistent radiological findings. Consequently, routine brain imaging is not widely recommended.  For decades, autism disorders have been considered life-long disorders without curative therapies. Recently a new therapeutic approach aiming primarily at improving and curing the two major diagnostic features of autism which are poor responsiveness to their name and poor eye contact, has been increasingly used. Injectable cerebrolysin is the main therapeutic component in this new therapeutic approach. Patients and methods: A 6-year-old girl who initially presented with autism disorder features in early childhood, responded remarkably to a six-month course of injectable Cerebrolysin, but later regressed after treatment discontinuation and subsequently developed focal seizures. Results: A non-contrast CT brain scan revealed asymmetric cortical atrophy predominantly in the left posterior frontal and parietal lobes, particularly affecting the perisylvian region. The sulci appeared widened and the underlying white matter volume reduced. There were no calcifications or signs of progressive degenerative disease. Conclusion: This paper highlights a unique clinical entity where early childhood autism is associated with focal cortical atrophy and later development of epilepsy. The marked initial response to Cerebrolysin underscores the potential role of neurotrophic therapy in modulating neuroplasticity and improving functional outcomes even in patients with underlying structural abnormalities. The recurrence of symptoms and emergence of seizures following treatment cessation suggests a progressive or evolving neurological basis rather than a purely static neurodevelopmental disorder.

Keywords: Autism, Focal Epilepsy, Cortical Atrophy, New Clinical Entity.