Cerebral Allergy?

[aunt fran]

For the past 4 years, my nephew (age 17) has had 1 or 2 spells a year of what can only be described as psychosis.  He has a genetic neurologic condition called Pelizaeus-Merzbacher disease, but his periodic psychosis is not related directly to his disease.

The "spells" always occur in the summer, as soon as the weather starts to warm.  We thought they might be related to dehydration or overheating, but over time have concluded this is not the case.  The last three times he has experienced these periods of psychosis, we know that he was bitten by ants immediately before his behavior changed.  He likes to water the yard for his mother and at daycare, and ants climb up his wheelchair and sting him.  This has led us to research allergies that may be causing his problems.

My nephew is normally a very sweet and happy individual.  His intellectual abilities are at the level of a young child, and he is not able to communicate very well about his condition. When he experiences these spells, he becomes lethargic, to the point at times of being almost catatonic.  He does not want to eat.  He has paranoid delusions.  He has insomnia.  He is terrified of using the toilet and wets himself.  He has been suicidal and combative with his caregivers.  He is nervous, exhausted and pleads for help.  He has headaches and complains of stomach problems.  Ear, nose and throat problems with some elevated temperature almost always seem to accompany these episodes at the start.  He has rashes as well.

He has been treated by psychiatrists with a variety of psyhotheraputic drugs.  Some left him like a zombie, while others turned him into a monster who never slept.  None helped.  At age 13, when the first eqisode occurred, he spent a week in the hospital and was given any number of medications.  None made a difference.

He improves after roughly 2 weeks, and returns to his normal, lovable self.

I really believe these "spells" are related to allergies of some sort, possibly as a result of the ant stings.  We have had his house and yard treated for ants, but can't protect him from exposure to them at school, daycare or the playground.  He is experiencing the psychosis now and we have started giving him anti-histamines to see if they will help.

We are desperate to find the cause of his problems.  It is heartbreaking to see him in this condition.  His doctors (pediatrician, psychologist, and genetics physician) have essentially given up.

Any suggestions?????

[nurse12hr]

Given the extreme complexity of this situation, a large academic setting would probably be the best bet.  

My heart goes out to your family.  I also have a son (24)who periodically gets psychotic, and he is currently missing.

[aunt fran]

Thank you.  His neurologist retired and we are in the process of getting him referred to another.  We'll try to find one who is willing to consider the allergic responses to the insect toxins. Thanks again for replying.

[Kevin Kennedy, Ph.D.]

It is certainly true that some insect bites can result in both local and systemic complications. This is particularly true with people who are immobile and threfore subject to a greater number of bites/stings and the resulting increase in venom cemncentration in the bloodstream. I personally have not heard of a transient psychotic reaction of the sort you describe, but the seasonal and situational pattern do suggest the possibility. If a person has baseline neurological problems, it may increase the possibility of neurological complications from insect bites or stings. Perhaps through your son's neurologist you can receive an opinion from a neurologist who specializes in the area of neurotoxins or clinical toxinology.