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Autistic child diagnosed with a lesion in the thalamus. Headaches, urine incontinence and diarrhea. Need advice

Hello my son is 7 yrs old and has Autism and ADHD. Has been on Concerta for two years, now taking 54mg. He also is taking 8mg Melatonin to help initiate sleep. All was well. He is in General Ed Class 100% of the time. He is very high functioning and up until recently rarely showed any Autistic behaviors. In January of this yr he started having a lot of headaches. 11 to be exact. He had a CT scan in Feb which was normal. Then had an MRI a week and a half later Feb 13th, which showed a non-specific lesion in the posterior right thalamus. We saw a Neurologist on Feb 25th who prescribed 2mg periactin nightly for headaches and has scheduled for another MRI this time with contrast along with an MRS to be done May 2nd. Since mid Feb we have noticed a decrease in Hyperactivity and seen a huge increase in Autistic behaviors that we haven't seen since he was 2 yrs old. He is now having some problems at school where an aide needs to sit with him or pull him out for a break. The headaches subsided and went away but at the same time he started to develop diarrhea and he does not make it to the restroom. He is also having urinary incontinence. No other symptoms such as fever or vomiting. This has been an issue for the past two weeks. He is even having diarrhea in his sleep! 3xs so far. Went to pediatrician today who has ordered a stool culture. My Question Is Can all of this (change in behavior, urinary and bowel incontinence) be somehow connected to the right thalamic finding on MRI?
Asked On : Wed, 27 Mar 2013
Answers:  1 Views:  81
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Pediatrician 's  Response

Thank you for your query.

The description provided by you is suggestive of an increasing lesion in the brain which can explain:
1. The initial headaches.
2. Change in behaviour.
3. Urinary incontinence.
There can be bowel incontinence but you mention that your son is having diarrhoea which needs to be investigated.

As the full detail of the MRI finding is not present it is very difficult to suggest any further solution. It is advisable to repeat a MRI and follow the neurologist's guidance.

I hope I have answered your query to your satisfaction.

Wishing your son an early recovery.


Rajiv K Khandelwal
Answered: Fri, 7 Jun 2013
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