autonomic neuropathy, colitis, irritable bowel

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If an autistic-child has autonomic irregularities, the child's

intestinal health (or lack thereof) may be a factor (eg, 1). HSV

remains one of the pathogens that can enter via esophageal or intestinal

tissue and migrate into the vagus (2) (and beyond, eg, into the

amygdala; KA, Blessing WW et al). Ruling out viral

participations in an ASD child with dysautonomic symptoms seems valid

even for clinicians.

1. Scand J Gastroenterol 1993 Jul;28(7):638-42

Autonomic vagal nerve dysfunction in patients with ulcerative colitis.

Lindgren S, Stewenius J, Sjolund K, Lilja B, Sundkvist G

Dept. of Medicine, Malmo General Hospital, Lund University, Sweden.

Autonomic nerve function was evaluated in 40 patients with total

ulcerative

colitis and in 25 patients with irritable bowel syndrome by three

established

non-invasive tests based on the heart reactions to deep breathing (E/I

ratio)

and tilt (acceleration and brake index). None of the patients were

diabetic.

Most of the patients with ulcerative colitis were clinically and

biochemically

inactive; 10 had previously undergone colectomy. The results were

compared with

a control group consisting of 56 healthy individuals and 33 previously

investigated patients with Crohn's disease, 45% of whom demonstrated

autonomic

neuropathy (AN). Patients with ulcerative colitis had a significantly

lower E/I

ratio than controls in age-corrected values, indicating vagal nerve

dysfunction.

Altogether, 35% had signs of AN. In patients with irritable bowel

syndrome 36%

had evidence of AN, a figure in agreement with observations from other

investigators. We conclude that AN is common in patients with ulcerative

colitis, regardless of disease activity and previous colectomy. In

contrast to a

predominantly sympathetic dysfunction in Crohn's disease, AN in

ulcerative

colitis was vagal.

2. J Virol 1997 May;71(5):4103-6

Latent herpes simplex virus type 1 gene expression in ganglia

innervating the

human gastrointestinal tract.

Gesser RM, Koo SC

Using in situ hybridization, we demonstrated that latent herpes simplex

virus

type 1 (HSV-1) gene expression is prevalent in human adult nodose

ganglia. This

suggests that infection of gastrointestinal sensory nerves, probably

through

swallowed virus-laden oral secretions, occurs commonly and that HSV-1

reactivating from this site may play a role in recurrent

gastrointestinal

disorders.