Challenge in Identify Acute Psychosis in Autism: An Illustrative Pediatric Case - Abstract
Autism Spectrum Disorders (ASDs) are neurodevelopment disorders characterized by persistent impairments in reciprocal social interaction and communication, restricted interests, and stereotypical behaviors. Sleep problems in ASD are a prominent feature, many of which are often unrecognized. Psychiatric and psychotic morbidities can coexist, making differential diagnosis challenging between an exacerbation of pre-existing symptoms and an organic pathology of new onset. We describe the case of a 6 years old girl with high functioning ASD presenting new onset of subacute psychotic symptoms (vivid terrific visual hallucinations) and sleep disturbance (difficulty at falling asleep, frequent awakenings). Polysomnography (PSG) detected periodic legs movements during sleep (PLMs – Index 11), persisting during REM sleep, with dystonic features. A slight positivity detection of Anti-GAD Antibodies in serum and CSF was detected. Symptoms improved after corticosteroids and intravenous immunoglobulin treatment.