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Progressive Cogntive Decline
by cognitivelykaput, Nov 07, 2009 08:00AM
I've posted here a few times before, but since new issues have arisen and my symptoms just continue to worsen, thought I'd have another bash. I'm a 35 yr old U.K male, with no previous health issues, prior to December 2008, when the following problems started.
For the past 11 months I've been suffering from progressive cognitive decline. It's like my thought process has just been gradually breaking down more and more over this time. Now I'm at the point where I need assistance to wash, prepare meals, etc, as I just can't seem to follow any sort of sequences, or steps through to completion anymore. I feel incredibly drunk and dazed most of the time with this, along with having appalling short term memory.
Over this time, I've also developed insomnia, blurred vision at times, severe muscle twitching, shooting pains in hands and feet, and more recently have started to have what my GP tells me are hypogenic hallucinations, pretty much every other time I go to sleep - something which I've never experienced before, and are becoming increasingly scary.
Since these problems began, I've seen 4 different neurologists, a neuropsychatrist, and a psychiatrist, and have had 2 MRI's of the brain - 6 months apart - both of which have been normal, not to mention blood tests for all the normal things, and a whole bunch more of exotic conditions. The neuropsychiatrist did the standard sort of memory and IQ testing, which showed there was a short term memory deficit present, but general I.Q etc wasn't too bad.
The last 2 neurologists I've seen, both believe I have some sort of pseudo dementia type condition going on, having ruled out all the more obvious things, along with M.S, vCJD, and anything else more organic. I think such a diagnosis has been reached, as despite the issues which I'm presenting, I'm still able to articulate myself verbally fairly well, along with being able to recall details fairly well about when specific symptoms started, etc, which they inform me I wouldn't be able to do by now, if there was some sort of organic cause.
I'm having trouble getting to grips with such a diagnosis though, given I've been told it's normally something which predominately only happens in the elderly, who have some sort of underlying depressive condition. At onset of symptoms, there was no depression present whatsoever, and I was very happy and content in life!
I posed the question to one of the neuro's, of whether some sort of pseudo dementia / somatisation disorder would cause such severe muscle twitching, to which I was told 'no one has seen your muscle twitching', which I can only deduce means, no, it wouldn't. Plenty of people have witnessed it, just not any doctors, given it's sods law that it's not going to occur during the few minutes I'm being examined.
As my options now are somewhat exhausted where further investigations are concerned, I dont really seem to have much choice, other than to accept such a diagnosis, despite both myself, and friends, etc who've researched the topic on my behalf, finding it somewhat questionable, given my age and the fact I didn't have any sort of depression at the time of symptoms onset - certainly not that I was aware of anyway.
Has anyone ever heard of such a diagnosis being given, to a younger adult before, who had no prior history of mental health problems?
For the past 11 months I've been suffering from progressive cognitive decline. It's like my thought process has just been gradually breaking down more and more over this time. Now I'm at the point where I need assistance to wash, prepare meals, etc, as I just can't seem to follow any sort of sequences, or steps through to completion anymore. I feel incredibly drunk and dazed most of the time with this, along with having appalling short term memory.
Over this time, I've also developed insomnia, blurred vision at times, severe muscle twitching, shooting pains in hands and feet, and more recently have started to have what my GP tells me are hypogenic hallucinations, pretty much every other time I go to sleep - something which I've never experienced before, and are becoming increasingly scary.
Since these problems began, I've seen 4 different neurologists, a neuropsychatrist, and a psychiatrist, and have had 2 MRI's of the brain - 6 months apart - both of which have been normal, not to mention blood tests for all the normal things, and a whole bunch more of exotic conditions. The neuropsychiatrist did the standard sort of memory and IQ testing, which showed there was a short term memory deficit present, but general I.Q etc wasn't too bad.
The last 2 neurologists I've seen, both believe I have some sort of pseudo dementia type condition going on, having ruled out all the more obvious things, along with M.S, vCJD, and anything else more organic. I think such a diagnosis has been reached, as despite the issues which I'm presenting, I'm still able to articulate myself verbally fairly well, along with being able to recall details fairly well about when specific symptoms started, etc, which they inform me I wouldn't be able to do by now, if there was some sort of organic cause.
I'm having trouble getting to grips with such a diagnosis though, given I've been told it's normally something which predominately only happens in the elderly, who have some sort of underlying depressive condition. At onset of symptoms, there was no depression present whatsoever, and I was very happy and content in life!
I posed the question to one of the neuro's, of whether some sort of pseudo dementia / somatisation disorder would cause such severe muscle twitching, to which I was told 'no one has seen your muscle twitching', which I can only deduce means, no, it wouldn't. Plenty of people have witnessed it, just not any doctors, given it's sods law that it's not going to occur during the few minutes I'm being examined.
As my options now are somewhat exhausted where further investigations are concerned, I dont really seem to have much choice, other than to accept such a diagnosis, despite both myself, and friends, etc who've researched the topic on my behalf, finding it somewhat questionable, given my age and the fact I didn't have any sort of depression at the time of symptoms onset - certainly not that I was aware of anyway.
Has anyone ever heard of such a diagnosis being given, to a younger adult before, who had no prior history of mental health problems?
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I feel the neuro's have just both settled on such a diagnosis, because they're at a bit of a loss as to what's actually going on, and dont want to investigate any further.
Your post got me thinking....lets just entertain the idea that it could be psychological (which is a better option than a brain disease).
Can you think of ANYTHING at all that has happened in your life that could be described as traumatic? An accident, witnessing an accident, witnessing a loved one go through illness or dealth, being ill as a child?
Anything at all traumatic? Even if it did not necessarilily feel traumatic at the time?
(Sorry, my beckground is mental health - so I tend to explore that first!)
No, nothing at all comes to mind on the trauma front. The most traumatic thing to happen in all my 35 years of life, is what's going on right now.
When all this came on, there was no real stress in my life either, in fact life was pretty sweet. That's really why I find it so hard to accept such a diagnosis. I mean, if I'd of had depression around the onset of my symptoms, or even earlier in the year, etc, that perhaps hadn't resolved itself, it would kind of make sense.
Of course, as you say, I'd much rather it was something like what's been put forward, than something more sinister, but many of the symptom I have, just don't seem to fit with the profile of a psychological condition. Like for instance, from what I've been able to ascertain, muscle twitching is almost never psychological in cause.
No need to apologise btw - your comment was one of the most sensible and logical replies I've ever had since frequenting this forum.
I have been going through problems with my head horrible pain and noticed just today that I have a decline in cognitive capabilities as well. The Doc's can't find what is wrong me as well.
Have you been checked for parkinson's? I hope they can find the answers for you soon it so sux to be waiting so long. They are firing ahead with leaps and bounds in the medical field and the fact that you are so young chances are on your side good luck!
This is part of the problem I've had when in consultations with neurologists so far. Whilst my ability to articulate myself - especially verbally, is no where near as good as it was - especially where anything involving judgement, reasoning, opinions etc are concerned, I can with only minor difficulties, speak relatively clearly, and coherently about my health issues, as just simply talking about facts, seems much, much easier, than having to form an opinion say on a topical issue, or use any sort of reasoning skills.
Obviously this directly contradicts my symptoms of feeling very confused and muddled, and thus I'd imagine, has led to a potentially psychological diagnosis having been arrived at. As one of the neuro's I saw earlier in the month told me, if there was something organic going on, after all this time, you wouldn't be articulating yourself like you are now! Whilst to hear this sort of thing is obviously reassuring, the reassurance only goes so far, given that my symptoms in general, just continue to worsen.
None of the neurologists I've seen have mentioned Parkinson's. The issues I'm now having with movement have come on relatively recently - over the past 6-8 weeks I'd say. Prior to that, aside from the muscle twitching, and the shooting pains, my only issues were the cognitive problems.
I wish you all the best in getting to the bottom of your own health problems.
If in your distant past you were injured in, say, a car accident or had a bad childhood illness, either of those can cause insidious future problems, so review all that. I was in a wreck that hurt my back when I was a young adult, thought I got over it, until about 20 years later, and talk about cascading health issues! I was a basket case and didn't know why, muscle twitching, poor sleep, pain and suffering that even affected my mental outlook. I take lots of medicines to keep all that straight now. So, that's why I say to think of health-related incidents when you were younger.
On the psychology situation, or "it's all in your head," what I CAN say is, if about the time all this stuff started happening, you moved to a different city or changed jobs or anything remotely stressful that was going on that you didn't take too seriously, well, stress can disrupt sleep, and if your sleep has gone haywire, you can get the health picture you got now. Me, I'm living in a cold part of the country as an older adult, but grew up in coastal areas. I cannot STAND the furnace. Gas, oil, makes no difference. I have to keep the house humidified to keep from going nuts, because it disrupts my sleep. That's just an example of simple stress that people don't necessarily consider.
I am assuming you are not taking any medications at all now, so why don't you consider that SOME kind of stress is the culprit, for the sake of argument. To combat stress, hidden or not, and since you do indeed have sleep problems, an ordinary mild tranquilizer like Valium for short-term use (do NOT take SSRIs), along with talking to a psychiatrist for a few weeks, might help. In addition, for anybody who has stress in their body, which might be triggering your spasms, well, vigorous exercise on a regular basis, drinking plenty of water, and also some visits to a professional massage therapist will get tension out of the body, which has the additional benefit of helping you sleep more soundly. GG
Hi GG,
Thanks for your reply,
The cognitive problems had already been present for a good couple of months, prior to any noticeable disturbance in sleep. I've been taking tamazepam of more recent times, to help with the insomnia. I agree though, some sort of sleep study would be a good idea, given that a lot of strange things seem to be going on when I'm asleep or in a state of semi-conciousness at night. I can but only put forward this suggestion to my current neurologist though, and not 'demand one' as such.
Here in the U.K, if the treating consultant does not deem a certain test/investigation warranted, they will not agree to it. It took some convincing, just to get him to agree to perform a nerve and muscle study, because of the twitching and pains I'm experiencing, as he couldn't see any twitching himself upon observing me for a few minutes. All comes down to cost!
I saw an endocrinologist back in September, who did the most thorough blood tests. Thyroid Profile / T3 / Cortisol / Glucose / HbA1c / ACE / ANA / ESR / CRP / Lyme / Calcium / B12 / PTH / Folate, as well as checking for various toxic poisons, which could account for such neurological symptoms that I'm experiencing.
The possibility of M.S has been excluded by three different neurologists (one of whom was an M.S specialist), and there were no lesions or the like on the two mri's I've had this year. They all said too, that my rate of cognitive decline, and late emergence of more 'physical' symptoms, just doesn't tally with M.S.
As mentioned in my reply to Lexy, there was no stress in my life at onset of symptoms (it was probably the most stress free period of my adult life), nor has there been any trauma, in either my childhood, or in my adult years. I also wasn't on any medications at the time that symptoms first emerged.