What makes ASD different from TLE and other conditions?

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What makes ASD different from temporal lobe epilepsy, that can have a host of similar symptoms (sensory disturbances, social problems, emotional problems, obsessive thoughts)?
These two have a high rate of comorbidity, too. So, I wonder what are the main differences that let the doctors tell whether it's ASD, TLE or both?

The first and most obvious thing is that temporal lobe epilepsy (TLE) is a chronic disorder of the nervous system characterized by recurrent, unprovoked focal seizures that originate in the temporal lobe of the brain. Autism presents no such characterization.

Temporal lobe seizures begin in the temporal lobes of your brain, which process emotions and are important for short-term memory. Some symptoms of a temporal lobe seizure may be related to these functions, including having odd feelings — such as euphoria, deja vu or fear.

Symptoms of Temporal Lobe Seizure

An unusual sensation (aura) may precede a temporal lobe seizure, acting as a warning. Not everyone who has temporal lobe seizures has auras, and not everyone who has auras remembers them.

The aura is actually the first part of a focal seizure before consciousness is impaired. Examples of auras include:
* A sudden sense of unprovoked fear or joy
* A deja vu experience — a feeling that what's happening has happened before
* A sudden or strange odor or taste
* A rising sensation in the abdomen, similar to being on a roller coaster

Sometimes temporal lobe seizures impair your ability to respond to others. This type of temporal lobe seizure usually lasts 30 seconds to two minutes. Characteristic signs and symptoms include:
* Loss of awareness of surroundings
* Staring
* Lip smacking
* Repeated swallowing or chewing
* Unusual finger movements, such as picking motions

After a temporal lobe seizure, you may have:
* A period of confusion and difficulty speaking
* Inability to recall what occurred during the seizure
* Unawareness of having had a seizure
* Extreme sleepiness

Source: Temporal lobe seizure

There are different types of panic attacks just as there are different types of epileptic seizures. Panic attacks can manifests as major meltdown, a panic attack, anxiety attack, trauma attack, a panic disorder, and tonic immobility.

The deepest and most severe is called tonic immobility. So I suspect you are trying to compare a temporal lobe epilepsy with tonic immobility.

When any organism perceives overwhelming mortal danger with little or no chance for escape, the biological response is a global one of paralysis and shutdown. Ethologists call this innate response tonic immobility.

For an individual this state of tonic immobility is very scary one to experience. The individual literally lose control over their actions. Highly traumatized and chronically neglected or abused individuals are dominated by the immobilization/shutdown system. Chronically traumatized individuals tend to be plagued with dissociative symptoms, including frequent spaciness, unreality, depersonalization, a general disengagement from life and various somatic symptoms and health complaints.

In the fight-or-flight response, the objective is to get away from the source of threat. Our mind triggers the release of a hormonal cascade of chemicals within our bodies to prepare all of our muscles for this escape by increasing their tension level, our heart rate and respiration increase, and our whole basic metabolic system is flooded with adrenaline. Blood is diverted to the muscles, away from the viscera. The goal is to run away, or if we feel that we can't escape or if we perceive that the individual that's trying to attack us is less strong than we are, to attack them. Or if we're cornered by a predator—in other words, if there's no way to escape—then we'll fight back. Now, if none of those procedures are effective, and it looks like we're going to be killed, we go into the shock state, the tonic immobility.

Being physically, mentally, and emotionally immobilized by overwhelming stress permits a traumatized individual to not to feel the harrowing enormity of what’s about to happen to them, which in their hyperarousal state might threaten their very sanity. In such instances some of the chemicals (i.e., endorphins) secreted functions as an analgesic, so the pain of any injury (to their body or psyche) is experienced with far less intensity.

Humans experience this frozen state as helpless terror and panic. It is a state of utter hopelessness. Tonic immobility is the last-ditch of defense cascade, occurs in traumatized humans. Immobility correlates with tachycardia and low heart rate variability. Cardiac deceleration response is hypothesized to be part of a freezing-like defensive response that includes reduced body sway and heart rate deceleration. Tonic immobility is an innate behavioral response characterized by temporary, profound physical inactivity, analgesia, and relative unresponsiveness to external stimulation that occurs in response to inescapable threats. It is a form of disassociation similar to self-hypnosis.

When a person is in a traumatized state, they physically lose their ability to talk. One of the things that Bessel van der Kolk showed when he first started to do trauma research with functional MRIs is that when people are in the trauma state, they actually shut down the frontal parts of their brain and particularly the area on the left cortex called Broca's area, which is responsible for speech. When the person is in the traumatic state, those brain regions are literally shut down; they're taken offline. Some Aspies report that during a meltdown, they have difficulty processing speech. It is like hearing white noise. Others indicate they lose their ability to think in words. [When the brain collapses down into the core brain, it is becoming a preverbal brain like that of an infant that hasn’t learned to speak.] Rather their brains revert back to thinking in terms of pictures and video clips and when they try and communicate, their words come out as gibberish. Others indicate they lose their ability to process all sensory inputs. Sometimes during a panic attack, the whole body goes limp and the person will collapse on the floor.

Nicole Martin described the three stages of her deep panic attack:

Stage 1: The Fog
When an attack is in its earliest stage, I enter a sort of mental fog or blur. If I am reading a sign, I know what I am seeing is numbers or letters. However, my brain cannot process them. I cannot follow what I am trying to read and lose focus quickly. Sounds around me become static-like, as if they’re all jumbled and indistinguishable. For instance, when you are fully submerged underwater and it’s raining out, you might hear the raindrops hitting the water, but you’re unable to pinpoint where they’re coming from. Or like the game you play as kids in the pool. You talk to each other underwater and try and guess what the other is saying. [feeling of unreality or being detached from the world]

Stage 2: Senses Awry
As my hearing starts to get muffled, my fingertips have grown numb [numbness] and my stomach feels cold, as if I hadn’t eaten in days. My mouth is dry, and I get an iron taste in my mouth, as if I were just sucking on a dirty penny for the last hour. In this stage, my husband has noticed from an outside perspective that I’m within the onset of a panic attack. According to his description, I’m expressionless, and my responses become delayed or I don’t respond at all. [shutdown of left cortex called Broca's area, which is responsible for speech] I’m almost zombie-like. As my brain begins to catch up with the rest of my body, I enter fight-or-flight mode, with fight stuck on max. My heart rate rises rapidly [heart racing] and my breathing becomes labored, entering the hyperventilation phase [shortness of breath]. Within seconds it becomes difficult to breathe, my legs weaken and I can barely keep myself upright [tonic immobility].

Stage 3: Shivering
This final stage tends to last from 15 to 30 minutes depending on the circumstances prior to the onset. At this point, my body manages to both collapse and yet stiffen [tonic immobility], with my arms clenched to my chest [chest pains]. It feels like I lose control of my muscles [fear of losing control] as I begin to shiver uncontrollably — but this is not a seizure, it is shivering. [shivering – method used by animals for venting unused stress energy after a fight/flight response]. It’s as if someone has thrown me into a freezer [chills], and yet I’m sweating at the same time [sweating]. And in my head, it’s as if there’s a horribly filmed home movie from my childhood stuck on a sort of fast-forward/repeat mode of the abuse I suffered in my childhood. During this stage, I tend to partially blackout. I can still hear what’s going on around me and see, but I cannot remember exactly what’s happened or how much time has passed after I’ve come out of my episode. I just remember bits of sounds and people’s faces.

Let's see...

Does TLE involve sensory and emotional burnout that can lasts for days involving to episodes or what you thought similar to meltdowns?
Or days and longer dealing with a form of exhaustion that involves significant amount of physical, mental and emotional vulnerability?
Does this condition involved days of recovery after spending considerable amount of time spent with 'triggers'?
Do those with the condition always feel like aliens among humans, regardless of social skills and emotional aptitude?
Are those with said conditions regard their behaviors as obstructive to learning or regard their condition has different learning growth rates and styles?
Are their 'symptoms' similar to autism contextualized or consistent throughout the day or throughout lifetime as opposed to, say, unpredictable?
Does 'inappropriate behaviors' also involves any form repetition?
The loss of speech -- is it expressively similar to aphasia or mutism? The loss of motor coordination -- is it expressively similar to dyspraxia? And are these expressions consistent and contextualized within the individual or not?
The obsessive thoughts -- are they expressively similar to ADHD/ADD, OCD or anxiety disorders? If not, are those thoughts also involve interests and focus, concerns and fears? Or are they random? Are they specialized?


Long story short: I don't know how the doctors can differentiate the subtle differences between conditions clashing and overlapping one another. But if it's an acquired condition, it would be a bit obvious.
If it's innate, that'll be a question if it's an autistic or someone with the condition -- or both.

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