We noticed some mild cognitive issues with my mom three months ago and brought her to a neurologist. She did quite well on his initial cognitive exam. Brain MRI negative. Short EEG negative.
She was living independently, driving, paying bills, shopping, preparing her own meals.
Recently she began having hallucinations - especially of multiple versions of my sister. She then had a tremors episode, and then a full mind-wipe episode. We brought her to the hospital eight days ago.
Long EEG revealed "abnormal discharge" - apparently associated with seizures. She is now on Keppra (anti-seizure drug.) MRI with contrast negative. Spinal tap (aka lumbar puncture) results pending.
Over the last eight days, her entire personality has entirely vaporized. She has morphed into a different person - seemingly dementia/delirium symptoms, but the rapid onset seems too suspect. She barely knows who we are or what's going on at this point and nothing she says makes much sense. I feel like something is being missed.
Any thoughts/advice?
Are there any truly extraordinary specialists out there we might be able to consult with?
Thanks.
Mike
My prayers are with you.
Also, have her Thyroid levels tested. Check for medication interactions, as well as vitamin or mineral deficiencies.
>> Abnormal EEG due to the presence of occasional bitemporal slowing and mild generalized slowing
>> There are no changes noted from the initial report. There continues to be occasional focal slowing over the left more than right temporal regions; at times the slowing is semi-rhythmic.
Doctor's report states:
>> EMU showed bitemporal epileptiform sharp waves and
patient was started on Keppra for likely seizure.
Also search this site regarding hospital induced delirium. There was a post last week I think. More common than one would think.
It's one of the reasons that folks should HAVE a PCP, in my opinion.
Finding a geriatric psychiatrist (board certified) can help understanding biological influences on behavior, and a neurologist with a gerontology focus or interest can be the most helpful one in trying out other possible treatments. It may take some time, but get on waiting lists for new appts, call weekly for cancellations, etc. Hope your mom regains some of her 'old self'.
We noticed improvement over a the span of a few days, but now the delusions / hallucinations have returned again - primarily at night. For this the doctor prescribed Seroquel "as-needed."
We have an appointment for another neurologist opinion, though the spinal tap results look like they are likely quite conclusive in conjunction with the symptoms. We are primarily shocked at how quick the recent decline was.
As much as I knew this is a horrible disease, I probably never truly grasped how devastating and stressful this is on families and caregivers. I get that there is no easy road, though it seems as if it would have been just a little "easier" if there had been a slower decline and if we knew what was going on so we could have at least had time to better prepare and adapt. These have been the most difficult and stressful few weeks my sister and I have ever endured :-(
Thanks for everybody's thoughts, feedback, advice and well-wishes - it's most appreciated.