Discussions By Condition: I cannot get a diagnosis.

rapid memory loss

Posted In: I cannot get a diagnosis. 9 Replies
  • Posted By: gavin70
  • February 18, 2009
  • 01:25 PM

hi
My father is currently ill in hospital with no diagnosis.
He fell ill around Xmas 2008 (7 weeks ago). He is 64 years old.
Since Xmas until around one week ago he has had fairly rapid memory loss. Over the course of the previous week the rate of decline has rapidly increased, e.g. he does not know he is in hospital, where he lives, cannot really hold a conversation as he tends to respond with a random statement, and immediately forgets what he or you have just said. He is also starting to have hallucinations, e.g. dogs in the hospital, and seems to be increasingly paranoid, although he is generally happy.
He has had Cat scan and MRI scans, which have identified a small cyst on his pituitary gland, although the neurosurgeon thinks due to its size this may be incidental to his symptoms. The scans do not show any change in his brain size, they do not suggest part of his brain is dying, nor is there any sign of bleeding or of other fluid.

In addition to the confusion./memory loss over the previous seven weeks he has had several "bad turns" which tend to last around a day, these symptoms include:
Full body tremors (remain conscious)
High (102+) temperatures
High Blood Pressure
Fast pulse 120bpm+

It goes without saying that all his family are extremely concerned, and would appreciate any thoughts (or experiences) people may have.

He has suffered with hand tremors for approx 10 years previously, and memory has occasionally not been 100% for quite some time

Thank you

Gavin

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9 Replies:

  • That's very sad, Gavin. I had a friend who was 55 and in six months went from a working teacher to death in a very similar manner. No final diagnosis was made available to me but it seemed like some unspecified prion disease. There was no family history. Whatever your fathers problem is I wonder if the turns are related to something affecting his lower brain where it controls homeostasis? Good Luck Kym
    Kymmaree 8 Replies
    • February 18, 2009
    • 09:45 PM
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  • Okay, I usually am hesitant to mention it, but it should be confirmed that he does not have a UTI. Urinary tract infections are the most frequent cause of altered mental state in older persons and although it's typically one of the first things checked, it just needs mentioning here. The hand tremor, if of the pill-rolling variety wherein the thumb and index finger are involved, would be suggestive of a parkinson's tremor although I would wonder whether it is in both hands or just one hand. I would also consider the the cyst at the pituitary to be unremarkable with regard to his present symptoms. It's a relatively common finding. The fevers, tremors and spike in BP would initially suggest some type of dysautonomia, again a factor present in certain neurological disorders. But again, these symptoms could be easily consistent with an infection. Also realize that persons with former memory decline very often experience abrupt changes in mental state while hospitalized, so some of the characteristics being described would be attributed to hospitalization itself. The unrelated statements or responses he is making is known as tangential referencing or speech. It is a common sign among some persons with certain neurodegenerative diseases, but depending upon the specific character of the speech, may also simply be related to general confusion. There are a number of neurodegenerative processes that could be responsible, but it's absolutely not a good idea to have him undergo a neuropsychological evaluation while hospitalized. Again, it needs to be reaffirmed that no UTI or other infection is responsible for the acute altered mental status. You also do not mention his medication regimen, which would be of some importance, although I would feel certain that this facet has been evaluated at this point. Once he is stable and his cognitive status has returned to more of a baseline presentation, I would recommend a full evaluation by a behavioral neurologist that includes a full neuropsychological battery to determine any patterns that may suggest an underlying process. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • February 19, 2009
    • 00:32 AM
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  • Thank you all for the kind words and replies. As things stand, we are now waiting for the results of 8 separate blood tests, although I am uncertain what they are testing for (hormone imbalances?) He was tested for UTI and other issues, eg kidney cancer via various scans, xrays, blood and urine tests and an cystoscope. He has traces of blood and protein in his urine, but no infections nor traces of other ailments. He is currently on a course amoxicillin and paracetamol His hand tremor was a shake almost as if he was cold. There has been no mobile phone mast citing or similar for the past few years near where he lives, nor has he ever been heavy user of mobile phones. The conditions with the symptoms that appear to be closest to his are: CJD – I have ruled this out in my mind as he has not lost his appetite and the involuntary movements are now less frequent and involve his whole body, basically they are seizures, not what would be expected in CJD Lews Body Disease – From what I have read it would be unlikely that he would deteriorate as quickly with this disease and we would also be able to identify a disease of this nature (albeit not specifically LBD) via the brain deterioration/shrinkage on the MRI scans Could it be the case that his cyst is simply is a very unlucky position, e.g. although it is not big enough to create issues due to pressure, it is placed on a part of his pituitary gland in such away as to create a whole series of issues as the gland cannot perform its normal functions?
    gavin70 1 Replies
    • February 19, 2009
    • 10:01 AM
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  • My mother went through very similar decline. The doctors were baffled and ready to give up. ALL testing also seemingly came back normal. Although I cannot remember the circumstances under which this treatment arose the doc's figured it couldn't hurt. We gave Mom extra large doses of magnesium and within a few days she began to come around. The tremors, hallucinations, paranoia, confusion all eventually disappeared. After about the third or fourth day of getting better Her temp spiked again. The Doc decided to give doses of bigger and better Antibiotics because that was a symptom that did not get better with magnesium. They gave the I V kind that is generally given just for M.E.R.S.A. although I cannot remember the name of it. Seems as though the blood tests and Urine tests did not show an infection of some sort that was appearantly there. The combo of magnesium and the antibiotic brought our mother back to us. Some say the magnesium was insignificant but she was getting better with it. The antibiotic was x-tra coverage that cleared fever.
    wdnewbee 3 Replies
    • February 19, 2009
    • 02:01 PM
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  • My mother's problem did not return.
    wdnewbee 3 Replies
    • February 20, 2009
    • 06:31 PM
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  • Get his minerals up; he's acidic ; dehydrated; low on potassium;;) water probably goes right through him Clean dead sea salt is the highest blood balanced minerals lots of chicken broth green food cut the unsprouted grains get some healthy oils into his brain and give him something to live for a new vision if you can't think take zinc real food home cooked spiced with love and goodwill B vits are what he needs for his mem but you must build the mins first then you won't have to feed him the whole farm to get him in tune again and teach him something new build him a new brain the last one is redundant There is no such thing as old age just old thinking
    Anonymous 42789 Replies
    • February 20, 2009
    • 09:55 PM
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  • Has he had a spinal tap or a ICP check? Being an older person, he could be susceptible to simmering, subacute meningitis or encephalitis. The fevers make me wonder.
    MissPickwickian 15 Replies
    • February 21, 2009
    • 02:11 AM
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  • Gavin 70, The Doc that posts here said he felt certain that your fathers medicine regimen had been checked out. Make sure that it has. Do the research yourself if you have to. Look for bad mixes (should not take if you take.....) or contraindications for the elderly. Also side effects are often exaggerated in the elderly. they usually saysomething to the effect of Sometimes side effects are worse than treatment especialy when there is usually another brand or medication that can be used. Hope your father is getting better.That something you tried has helped or that your fathers doctors have said it is beyond me and asked for other doctors to help.
    wdnewbee 3 Replies
    • February 21, 2009
    • 08:03 PM
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  • Okay, CJD would be quite unlikely in his case because the characteristic "hockey stick" sign associated with the symmetrical pulvinar and dorsomedial thalamic hyperintensity on imaging is unmistakable. Lewy Body Disease, or DLB, would also not be likely because the most characteristic feature of this disease is that hallucinations are the absolute first symptom, with parkinsonian features surfacing later in the course of the disease. His symptoms are also inconsistent with pituitary dysfunction, so again I think the cyst to be unremarkable with regard to his presentation. I would ask whether a vascular CT has been performed. Also, did they perform a lumbar puncture? Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • February 21, 2009
    • 11:03 PM
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