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Depends why it was done and what the complete pathological report shows
My husband had been feeling dizzy for several weeks but would not go to the dr., things progressed to forgetfulness , then he suddenly had what I thought was heart attack symptoms. While at the ER they determined it was not a heart attack, they thought it was vertigo & gave him valium @ anti vert. We followed up with an ENT, she told us it was definitely not vertigo but she thought it was something global. Something was obviously wrong, that day we saw family practice doc who actually sent us to the ER, he knew something was wrong but was not sure if it was heart related or something else. While at the ER my husband began getting paranoid, I thought he was just nervous but then he began thinking that the nurses were trying to take his body parts!! This is when things quickly took a turn for the worse, security had to be called, etc. . They were able to do an MRI @ it didn't show signs of stroke or anything that would be causing this so they wanted to keep him overnight for observation, things got worse and he was presenting as acutely psychotic, a 1013 was issued and the following morning he was taken to a psych hospital. He was given haldol and other meds, at the ER, after 10 days of anti psychotic meds in the psych hospital, he was not getting better, the dr there sent him back to the ER for fear that something medical was being overlooked.
10 days in ICU, due to a coma type state, confusion, and loss of memory, Neuro consults that resulted in spinal tap that showed elevated protein in csf, multiple CT & MRI's but nothing found that could be the cause. Steroids were given but no immediate results. Infectious disease doc consult with many tests and no results. He was released back to the psych hospital. Meds were changed and he did progress enough to be in the outpatient program, but still just wasn't "right", I could notice daily changes and suddenly he started with "dementia type" symptoms, not being able to put his shoes on, took a bite of a plate when given some food, etc. these symptoms were very rapid and we went back to ER. Neurologists did a work up in ER, they thought it was definitely something medical not psychiatric. He's was admitted and during his over 3 week stay was given a pet scan, gallium scan, diagnosis ranged from limbic encephalitis, to frontal lobe dementia, encephalopathy nos. he was given ivig, steroids and no immediate results, nothing definitive was found from any testing and a brain biopsy was ordered as a final test to try to determine what was going on.
Right frontal lobe biopsy showed reactive astrocytes and minimal gliosis, nothing that would be the cause of what was happening. He eventually started improvement, had to go to rehab for speech, cognitive and to get strength to walk. During his rehab I was told he had lack of insight, this still is an issue, he refuses to follow with docs ( it has been 2 years since his episode) he thinks that because nothing was found on MRI's scans, etc that nothing is wrong with him. His theory is that it was a virus and it's gone now.
I am very frustrated and need to know something.....my fear is that all of the meds, the steroids, the ivig, the time he spent in a coma type state without eating ( he had to have nasal feeding tube then a peg) allowed whatever was happening with his body to clear up, and that with his neglect of care it may just be a matter of time before whatever happened will happen again.
All of his tests were not normal ie, elevated protein in csf, elevated blood ammonia, tachycardia, abnormal eeg's, etc but nothing obvious for cause. Tumor markers, anti hu, cjd negative, Lyme disease negative. Neuropsych testing shame some moderate deficits.
10 years ago he did have a skin lesion that tested positive for sarcoid but he didn't follow up and has had no more skin lesions, other than that as we know he has no prior concerns. He has never had a psychotic episode, has never been on medication for anything.
Currently he is at home, has resulted with his day trading career, but the immediate family notices that there is something that is not right, there are bi polar type qualities, I believe he is depressed, always negative and a huge disconnect with our children. I worry constantly about him being in charge of finances and he gets very defensive and refuses to see the need that I have for him to follow up with docs and have my concerns addressed, he pulls the disabled card when asked to do something, he spends most of the day on the sofa on the laptop, eating seems to be a priority for him, he is obese and does nothing about it.......it goes on.
I was told that whatever he had was possibly degenerative and was just not currently showing up on tests, is it possible for him to return to a functioning state with no damage? My fear is that this is only a temporary situation and he will relapse. Current diagnosis is encephalopathy NOS.
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