9 year girl with decreased cognitive ability, lethargy, puffy face, hair loss

[hopefulmom301]

I have a 9 year daughter.  These are her symptoms since January 2008.  Started with hair loss (60%)week 1, then rash on legs and trunk (now face too)week 2, then weight gain, puffy face, lethargy, extreme behavior changes (week 3), and ended with her losing her ability to read, write or comprehend simple sentences week 6.  She started to see new hair growth, weight loss and the return of her mind in March.  Since then everytime we get a virus it usually is preceded by hairloss, puffy face, lethargy and a vacant or slow mind.  It is still happening 1 - 2x's a month.  We have done MRI, xrays, tons of blood work and are still working with no diagnosis.  My biggest concern is her mind - how it can be sharp and then not working the next day.  School is just around the corner and would love to figure this out!

Thanks for your help!

[hopefulmom301]

We are going to see a neurologist at Children's Hospital in Oakland, CA  next week and an endocrinologist at UCSF since a lot of her acids and other things are out of whack.  What kind of overdoses should I look into?  Any suggestions?
Thanks for your help.

[Kevin Pho, MD]

Can't say without evaluation.  I agree with the MRI.  Such an acute change would require an exclusion of infectious causes.  It is likely that the blood work your daughter had would have ruled this out.  

Overdoses or poisonings should also be considered given the relative acuity of the symptoms.

A referral to a neurologist should be done.  If an infectious causes is suspected, an infectious disease specialist should also be seen.  

The workup preferably should be done at a major academic medical center.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com