I believe that parents, such as Bernie Rimland, have promoted our modern understanding of autism. Indeed, I have learned more about the clinical aspects of autism by reading autobiographical accounts than by reading medical textbooks. It is therefore unsurprising that throughout the years when diverging opinions regarding autism have erupted between physicians and parents, it is the latter’s point of view that has carried the day. It stands to reason that nowadays when a controversy arises I try to understand both sides of the argument before making an informed decision. In the present blog, I will risk wasting everybody’s time in discussing a subject that has been repeatedly broached in the literature and offer my own take on the role that mercury may (or may not) have on the genesis of autism from the perspective of a neurologist and neuropathologist. I won’t cover the MMR controversy because I have not found any credible evidence to support a role for the measles virus in autism.
The art of diagnosis requires that in order to define the nature of a given affliction in a patient we take a comprehensive look at the clinical history and presenting signs, symptoms, and laboratory results. This practice is all the more important in Neurology as the brain is a heterogenous organ and different conditions can target specific portions of the same. This has led some clinicians to elaborate the concept of pathoclisis or selective vulnerability of the brain for given insults. In similar fashion efforts at parcellating the brain into regions have also used regional vulnerabilities to injury. As expected, the resultant map called pathoarchitectonics, differs from other maps using cellular or chemical criteria in their parcellation schemes, i.e., cytoarchitectonics, chemoarchitectonics.
There are several distinguishing clinical features that define intoxication with organic mercury. This would be a person with visual deficits whose blindness is marked by a progressive concentric constriction of his/her visual fields. There are difficulties in standing and running. Hand movements may become clumsy. Overall movements of the extremities are jerky and broken down by irregular accelerations and decelerations. It may be difficult for affected individuals to reach for a target, and when the hand or finger approaches its aim it may develop a side-to-side rapid movement or tremor. This tremor may also involve the lips and tongue. Speech is interrupted by variable intonations. Some individuals may also present with motor or sensory findings due to involvement of peripheral nerves. The mental state may be marked by confusion. Neuroimaging methods will reveal cerebral atrophy, with areas of tissue attenuation in the brain regions that process visual information and coordination (cerebellum). Brains from mercury poisoned individuals coming to autopsy show diffuse loss of neurons throughout the cerebral cortex, most marked in the anterior portion of a fissure (calcarine) involved in vision. Another area of the brain, the cerebellum, seems to be specifically targeted with marked loss of a specific type of neuron called granule cell.
Personally, I would have never confused the clinical picture of mercury intoxication with autism. The symptoms, including the clumsiness, are widely different for both conditions (see https://corticalchauvinism.wordpress.com/2013/02/01/clumsiness-and-autism/). In mercury poisoning the brains get smaller and become atrophied with certain areas of marked susceptibility. Brains of autistic individuals, on average, tend to be bigger, specially depending on developmental age. Even in the cerebellum, where abnormalities have been found in both conditions, the type of cells affected is very different. In mercury it is the granule cell while in autism it is the Purkinje cells (probably due to hypoxia, more on a future blog). So, mercury intoxication provides a fingerprint for its involvement based on both clinical, laboratory and pathological data. This fingerprint is not present in autism.
Since most of the controversy about mercury involves thimersoal (a preservative found in vaccines), I would find a propo to cite a recent press release regarding the position of the American Academy of Pediatrics and the World Health Organization (http://pediatrics.aappublications.org/content/131/1/152):
«A draft treaty under consideration by the United Nations Environmental Program has been prepared to greatly reduce global health hazards from environmental mercury. In response to the draft treaty, the World Health Organization urges removal of a provision in the treaty that calls for a ban on thimerosal (which contains ethyl mercury) in vaccines, a position recently endorsed by the American Academy of Pediatrics (AAP) and the US Public Health Service (USPHS).»
«Removal of the ban on thimerosal-containing vaccines (TCVs) represents a significant reversal of the position expressed in an AAP/USPHS joint statement in 1999 that called for elimination of mercury in vaccines and the subsequent actions taken in the United States. Understanding the circumstances that led 14 years ago to the 1999 statement and the knowledge accumulated in these subsequent years can reinforce the importance of the 2012 AAP/USPHS position. AAP representatives and other members of national pediatric societies within the International Pediatric Association advocating for deletion of the provision banning TCVs need to know why the elimination of thimerosal was initially called for in 1999 but is no longer indicated.»
This whole controversy is no longer about mercury and autism but about the lives of innocent individuals. Many people have died or suffered because of lack of vaccination. It should be clear by now that it is not the mercury in vaccines that causes autism.
Cortical Chauvinism 
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Reblogged this on Cortical Chauvinism and commented:
A couple of weeks ago I published a blog about the work of Andrew Wakefield. Although some viewers answered kindly with information meant to rebuke me, the visceral response from others has been quite violent. Besides serious physical threats, there are abusive remarks and other nonsensical comments. Some of the readers have gone over previous blogs now finding new evidence for my “deranged” way of thinking. One comment, for example, came from a reader who appropriately named himself “Smarter than You”. His comment was as follows: “Wow, this is how you draw your conclusion that mercury is not involved in Autism? Looks like you did about 5 minutes of google research here pal. Very shortly you are going to wake up and realize that you shouldn’t talk about something when you don’t even have the most basic understanding of either Autism or Mercury. I can’t wait to finally educate people like you”. Actually, I am a Board Certified Neurologist who did training in Neuropathology at Johns Hopkins. I served as a Medical Examiner in both Washington, DC and Maryland. I recently came back from being one of the opening plenary speakers at the annual American Association of Neuropathologists. I think that my education has extended over 5 minutes of internet search. However, you can judge the criticized blog by yourselves.
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How very sad. It is a shame that people like this don’t seem to understand that they are their own worst enemy; to convince people that your controversial claims are valid, the worst thing you can do is come off as tin foil hatted know it bully.
There are a lot of passionate people on the autismnet and you are bound to run into some of them if you mention certain topics. I happen to think that a small fraction of them did witness *something* happen to their child post vaccination. What that was, what developmental delays were already present, what pre-existing genetic or environmental conditions contributed to that change, and whether it could have been triggered by *other* insults are all very much open questions. At this time, there doesn’t seem to be very much interest in trying to dig deeper, a situation I imagine won’t change much.
I’d think that witnessing a change in your child, and then being told that your senses had deceived you could be very traumatic (not that you told anyone that). These are the internet voices that become the loudest, more inconsiderate, and frequently, least interested in learning outside of a preconceived set of ideas. For a community that has so many needs, this is a significant fracture that I doubt will be mended anytime soon.
I hope that you don’t let attacks dissuade you from blogging, I appreciate your content.
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Thank you so much for your comments. They are deeply appreciated. Curiously I am in favor of changes in the vaccination schedule. I also believe that the proper questions were not answered by the Omnibus Proceedings. However, I do not believe in Andrew Wakefield and believe he has dragged the whole movement down. I also do not believe that mercury is the culprit although it should be removed from vaccines.
As an aside the incept cases examined at the Omnibus proceedings all had a major reaction to vaccination, including the equivalent of stupor and seizures from which they never recovered. That should have been the starting point of the investigation. Instead lawyers directed the initiatives in the trial.
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Hi there:
I thought the reason for the controversy was that there were studies on both sides – some showing harm, some showing no harm. Pubmed has links to several articles that discuss thimerosal and how some children may be hypersensitive – http://www.hindawi.com/journals/jt/2013/801517/, http://publichealth.stonybrookmedicine.edu/phpubfiles/Hep_B_and_autism.pdf.
I think it’s wonderful that you have confidence in your diagnostic skills in terms of not confusing mercury and autism, but this was not the case with the plethora of physicians I went through who could not distinguish between my son’s lead poisoning and autism. Once we finally got on the right path (chelation, supplementation, correct therapies) he ‘normalized’ and lost his autism diagnosis. We went back to inform the physicians and many were shocked by his blood lead levels – a simple test they did not even run. I now serve as a parent liaison at my son’s current pediatric office and discuss the overlap of symptoms. It’s astounding at how many children actually have lead poisoning but are diagnosed by mental health professionals using CARS. I’m so grateful to the physician that correctly diagnosed my son. He is now in High School, straight A’s and plays on the football team. When I show people his videos, reports, etc., they cannot believe it and it provides great hope for parents whose children were recently diagnosed with lead. I wish you and all your patients the best.
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I thought I had already answered your comment but maybe I didn’t do it properly and it wasn’t posted. I am sorry to hear about your son’s plight with lead poisoning. Unfortunately this is not an unusual occurrence. It rears its ugly head primarily affecting children as lead based paints are still frequently found in older homes. Behavioral/neurological symptoms are common with lead poisoning, If not treated they could become permanent. I am happy about the positive outcome with your son. Thank you so much for your comment.
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Hi Manuel, I see two factions both equally blinkered in this area. I think it’s tragic that autism science has got derailed by the disputes about vaccines, but it was not helped by the seriously flawed official responses, with abysmally flawed «authoritative» studies put out to defend against both mmr and thimerosal, and vile deceitful character-assassination of Dr Wakefield. If authorities had stuck to honest/competent science it would have been much harder for so many to delude themselves that the very real cover-up was hiding an epidemic of supposedly «vaccine-damaged» children aka autistic.
I find the vaccine theories completely unable to account for the time series data in various countries and hence cannot have caused the increase but vaccines cannot be ruled out as causal in some individual cases. But as regards mercury, it comes also from dental amalgam. You mention organic merc above but amalgam emits elemental and inorganic. Furthermore you overlook a crucial point that timing is everything. The symptoms from infant exposure can be expected to be very different from those of later exposure.
Just a part of the evidence decisively implicating mercury in modern autism can be seen in my review of SSRIs/autism here:
http://www.researchgate.net/publication/261737290_Prenatal_SSRI_Use_and_Offspring_With_Autism_Spectrum_Disorder_or_Developmental_Delay/reviews/19047
And you can see the failure of sham «experts» to dismiss that in the following:
http://www.autismcauses.info/2008/01/peer-reviewers-of-pseudoneurotoxicology.html
But there’s a whole lot more which leads me to conclude that the change to non-gamma-2 amalgams has caused a tenfoldish increase of autism, and exactly concurrent fourfoldish increase of adult mercury disabilities. Your commentary above does nothing to challenge any of that evidence.
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Thanks for the comments Robin. Although I do not believe that the evidence stands to support a role for either the measles virus and autism, I do believe that more research is needed. I also urge caution and chose to err on the side of patient’s safety, thus advocating for a revised vaccine schedule. My own studies in regards to neuropathology and minicolumns in particular suggests that they may be be «short-circuited» when stressed. The incept cases at the Omnibus Proceeding showed this with violent reactions to their vaccination, high fevers, stupor and even seizures. Not coincidentally autism or autistic behaviors have been noted as prompted after febrile seizures. So, I believe there is a lot more research to be done on the subject. Thanks again, I hope to hear from you often in the future.
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Plus, see this in video of Minamata the cat at 1.54, and human at 1.59. Seriously nothing there?
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The video is very striking and there is no doubt that it is highly toxic. I think that we should avoid it as much as possible. This is only common sense. However, I am not certain about its relevance to autism. The blog points out (also shown in your video) that the symptoms of mercury poisoning and autism are not similar. I would take this further, just to say that the observed pathologies are also different.
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«I would take this further, just to say that the observed pathologies are also different.»
Indeed, but one would expect both symptoms and observed pathologies to differ depending on whether the mercury impacts during critical development phases or in a more massive way on a post-development individual. So I don’t find these to be evidence that mercury isn’t involved in autism (not to mention the other huge evidence I’ve linked to that it is).
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Yes you are correct. However, in the Minamata incident people were involved during all stages of pregnancy and postnatal development, from children to adults. Despite this exposure variability the symptoms (and pathology for those who unfortunately died) were similar and quite different from those observed in autism. I am not sure if I expressed the thought correctly.
Best regards,
Manuel
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You are correct that there was exposure at all stages of development. BUT not in the same way as dental amalgam which produces elemental mercury vapour constantly breathed in by the infant (and mother) (and also INorganic mercury passed umbilically and in milk). As further detailed in some of my unpublished articles this would make for a critical difference.
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