Seizures, memory loss - brother in trouble

[jiggsjedi]

My brother has been having memory problems, dizziness over the last few weeks.  Monday he was fine, but had a seizure at work and fractured his spine.  His condition worsens daily, and he can no longer remember people he works with.  He says people "don't look right", but can't elaborate.  Today another seizure resulting in dislocated shoulder as he fell.  MRI/CAT both negative.  Doctors are stumped.

NEED DOCTORS ADVICE -- PLEASE HELP!!!

[jiggsjedi]

My brother's condition continues to worsen.  He had another LP tonight and the CSF is being sent to the Mayo clinic in the US for testing.  He is also scheduled for a PET scan on friday.  His doctors now think he may have cancer somewhere, and his immune system is attacking his brain instead of the cancer.  The doctors are thinking he has encephalitis as a result of the body reacting to the cancer.

He mental state is now that of total confusion with violent outbursts.  His memory is nearly completely gone, and no longer recognizes me.  Tonight he physically attacked me because I wouldn't let him get out of bed.  He has been moved to a private room to limit his exposure to other patients as he has been yelling at others all day, and he has been sedated.

Please, if you have any suggestions, we desperately need them.

[jiggsjedi]

Update: His condition continues to deteriorate.  He can no longer visually identify people, but can by sound.  He is indicating people don't look "human" anymore; but can't elaborate why.

Initial tests from LP indicated elevated white blood cell count, more results pending.  Full abdomen/chest/pelvic CT shows nothing irregular.  Doctors are still stumped and are trying anti-viral medications.  They think their next course of treatment will be for auto-immune disease.  He is having another MRI of his brain tomorrow and they are going to scope his stomach to check on the disppearance of Crohns to see if that provides clues.  

We posed to the neurologist, that it might be Neurocysticercosis, as we felt that fit the symptoms and lengthy gestation period, and his wifes absence of symptoms (after dizzy spells) but he feels it is not that.

Any suggestions would be appreciated.

[jiggsjedi]

Thanks for replying.

His neurologist ordered an LP today, and said it will be about 5 days for results.

He and his wife determined that they both started getting dizzy spells and loss of balance after a trip to New Orleans.  They both ate catfish/alligator.  My brother, who has had Chrones disease for 20 years also noted that his stools were NORMAL after the dizzy spells began after this trip.  His Chrones is seemingly 100% cured.  His wife does not seem to be affected (yet?) but this trip was 4-6 months ago.  This seems a rather long time for the effects to be felt.  His wife said about 4-5 days after the trip they were both hit with dizzy spells and began walking into walls.  Her's passed a few days after with taking acidopholous (sorry if that is spelled wrong).

I have also noted since seeing him that his eyes are twitching rapidly when he is looking at you, and he says his vision is very bad now, he no longer recognizes me visually, but does remember me still.  He had his dislocated shoulder fixed, and was offered a surgery to reduce his chance of a recurring dislocation, but he has no memory of the talk about surgery.  His wife has been given power of attorney due to his degraded mental state, and she opted not to have the surgery on the advice of the anesthesiologist as they aren't sure what the problem is yet.  Overall, his memory is fading more each day, as he no longer knows what Chicken is, and short-term couldn't remember I was there the day prior.

I did some research on this fish issue, and the only thing I could come up with is ASP (amnesic shellfish poisoning).  What are your thoughts?  Can you clarify what a CSF is??

[DrNoopurMD]

Hi,

Infections and trauma to the brain can also result in epilepsy. He can also opt for a lumbar puncture and CSF exam to rule out infection in the brain. Please discuss this with his neurologist.

[jiggsjedi]

Also, since the "standard" tests have provided no answers, what other tests can we ask for to rule out infection/etc?

Thank you again.

[jiggsjedi]

Thanks for replying so fast.

He was put on anti-epileptics tonight as you suggested.  I'm sorry i didn't mention, he had an EEG on tuesday and the doctors indicated it showed nothing.  He has had a CAT and 2 MRI, and neither showed anything.

It should be noted the memory loss occurred before the seizures this week.  Last week we were out, and i mentioned my girlfriends name, who he has met countless times over the last year, and he had no memory of who she was.

Simple things, such as the time of day had no meaning.  But these were isolated incidents, and the memories did return with brief explanation.  He hid these from us until they became more apparent, but to my knowledge have been happening for months.

Since monday he had deteriorated quickly, following 2 seizures, and his memory is now very poor.  His speech is slowed, and his vision is abnormal he says.  As noted, he has no memory of the seizures occuring.

We have asked for him to be transferred to another hospital who has one of the best neurosurgeons in Canada, but the hospital says they aren't able to transfer him.  I think tomorrow, if he is well, his wife is going to sign him out and re-admit him at this hospital.

Any further advice/suggestions would be greatly appreciated as the doctors he is seeing, including his neurologist have no answers for us.

Dave

[DrNoopurMD]

Hi,

Thanks for writing in.
It is important that he be put on antiepileptic treatment as soon as possible since he has hurt himself twice already and that too really bad. It is also important that he undergoes EEG testing. Electroencephalogram helps to define the location of seizure activity in the brain. Please make sure that he takes complete bed rest. Temporal lobe epilepsy usually results in memory loss.
Anxiety, stress, high BP, low blood sugar, sleep deprivation can cause dizziness and loss of memory, since all the neurological causes have been ruled out.
Please schedule an appointment with his neurologist and discuss these issues with him. Keep us posted!