Sallie Bernard* Albert Enayati, B. S., Ch. E., M. S. M. E. Heidi Roger




НазваниеSallie Bernard* Albert Enayati, B. S., Ch. E., M. S. M. E. Heidi Roger
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Table VIII: Summary of Visual Impairments

Seen in Mercury Poisoning & Autism

Mercury Poisoning

Autism

Lack of eye contact; difficulties with visual fixation

Lack of eye contact; gaze abnormalities; problems in joint attention

“Visual impairments,” blindness, near-sightedness, decreased visual acuity

“Visual impairments”; inaccurate or slow saccades; decreased functioning of the rods; retinal sheen

Light sensitivity, photophobia

Over-sensitivity to light

Blurred or hazy vision

Blurred vision

Constricted visual fields

Not described


h. Physical Presentations

There is a much higher rate of autism among children with cerebral palsy than would be expected by chance (Nordin and Gillberg, 1996). Many autistic children have abnormal muscle tone including hyper- and hypotonia, and many are incontinent or have difficulty being toilet trained (Filipek et al, 1999; Church and Coplan, 1995). Several of the infants which Teitelbaum and colleagues (1998) observed showed decreased arm strength, and Schuler (1995) describes greater muscle weakness in the upper than the lower body. Impairments in oral-motor function, including problems chewing and swallowing, are common, as noted previously.


These impairments are seen in mercurialism as well. In the Iraqi and Japanese epidemics, many children developed clinical cerebral palsy (Amin-Zaki, 1979; Myers & Davidson, 1998; Gilbert & Grant-Webster 1995; Dale, 1972). Amin-Zaki et al (1978) reported muscle wasting and lack of motor power and control in most cases, complete paralysis in several cases, and athetotic movements in 2 cases, of postnatally exposed children. In the Iraqi babies and children, some had increased muscle tone, while others had decreased muscle tone. Abnormal reflexes, spasticity, and weakness were common. One child said “my hands are weak and do not obey me” (Amin-Zaki et al, 1974 and 1978). The 12 year old who inhaled mercury vapor exhibited weakness and decreased muscle strength (Fagala and Wigg, 1992). As in autism, muscle weakness from mercury poisoning is most prominent in the upper body (Adams et al, 1983). Acrodynia, for example, is marked by poor muscle tone in general and loss of arm strength in particular (Farnesworth, 1997). Finally, difficulty in chewing and swallowing, salivation, and drooling are common in children as well as adults; incontinence was observed in children in the Iraqi Hg-crisis (Amin-Zaki, 1974 and 1978; Pierce et al, 1972; Snyder, 1972; Joselow et al, 1972; Smith, 1977).


The presence of rashes and dermatitis is sometimes reported in descriptions of ASD subjects. Whiteley et al (1998) found that 63% of the ASD children had a history of eczema or other skin complaints. “Some children with autism are frequent scratchers. Gentle rubbing and scratching can become a calming self-stimulation; but when it becomes clawing, and there are rashes and open scrapes on the skin, a tactile intolerance can be responsible” (O’Neill, 1999).


Rashes and itching are common disturbances in mercury toxicity as well (Kark et al, 1971). A 4 year old with Hg poisoning developed an itchy, peeling rash on the extremities (Florentine and Sanfilippo, 1991). Mercury vapor inhalation caused a rash and peeling on the palms and soles of a pre-adolescent (Fagala and Wigg, 1992). An acrodynia victim described himself as a child as having severe itching and a constant burning sensation at the extremities, resulting in him rubbing his hands and feet raw (Neville Recollection, Pink Disease Support Group). Acrodynia symptoms in an adult poisoned by ethylmercury injection included pink scaling palms and soles, flushed cheeks, and itching (Matheson et al, 1980). In acrodynia the skin may be rough and dry, and the soles and palms are usually but not necessarily red (Aronow and Fleischmann, 1976). Thimerosal ingested by 44 year old man led to dermatitis (Pfab et al, 1996).


In autism, “signs of autonomic disturbance may be noticed at times, including sweating, irregular breathing, and rapid pulse” (Wing and Attwood, 1987). There may be elevated blood flow and heart rate (Ornitz, 1987). An increased incidence of acrocyanosis has been observed in Asperger’s syndrome. Acrocyanosis is an uncommon disorder of poor circulation in which skin on the hands and feet turn red and blue; there is profuse sweating; and the fingers and toes are persistently cold (Carpenter and Morris, 1991).


Sweating and circulatory abnormalities are also common in some forms of mercury poisoning. Acrodynia in adults and children results in excessive sweating, poor circulation, and rapid heart rate (Farnesworth, 1997; Matheson et al, 1980; Cloarec et al, 1995; Warkany and Hubbard, 1953). The 12 year old with mercury vapor poisoning sweated profusely, especially at night (Fagala and Wigg, 1992), and elevated blood pressure has been reported in exposed workers (Vroom and Greer, 1972). Autonomic system abnormalities can be caused by disturbances in acetylcholine levels, known to be deficient in both autism and Hg poisoning (see neurotransmitter section below).


Table IX: Physical Disturbances

in Mercury Poisoning & Autism

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