Abstract
The examination of typical and atypical cases of infantile autism for which intensive follow-up studies have been performed over a long period of time should be of value for the study of autism. This is a report on an unusual case of autism with obvious cerebral organic signs observed from infancy to 24 years of age. The neuro-and psychopathological findings of this case are as follows; 1) Clinical seizures which began at 7 months of age, have been under complete control by anticonvulsants since 6 years of age. 2) The EEG always revealed spike-and-slow-wave complexes and slow dysrrhythmia in basic activity but showed no clear-cut evidence of focal sign. CT scanning, however, revealed high-density foci in a deep site of the left temporal lobe. 3) A correlation between the clinical seizures and the foci in the deep site of the left temporal lobe remains unknown and the possibility of temporal-lobe epilepsy of this case was not substantiated because the clinical seizure pattern and the EEG pattern of abnormality do not match well with the definition. 4) A survey of the literature on the correlation between the neuropathological findings and clinical courses of infantile autism such as a refraction of early developmental pattern and/or chronically schizophrenia-like state from puberty to the present time was made, from which no understandable conclusion was obtained. 5) Such behaviors as mood-lability and impulsive violence in early school years in this case appeared similar to the behavior-pattern of Strauss syndrome. Therefore the possibility of a partial continuity of the clinical pictures of infantile autism and of Strauss syndrome was proposed. 6) We noted some unusual characteristics of this case for infantile autism; the lack of echolalia and of delayed echolalia with the presence of a severe degree of repetitiveness and of delayed violence. 7) A mild degree of mental retardation was found (IQ 59, WISC) at best, but that is far below the score at present.
