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Suggest Remedy For Confused Speech, Memory Issues And Elevated Arrhythmia
Question: Admitted to emergency dept. BP 177/154 pulse116 chest pains. not responding upon arrival. elevated arrhythmias, dehydration. difficult to get arrhythmias down to manageable levels. weak, unable to sit or move unaided. Previous 3 weeks bed bound due to infections and virus treated by amoxicillin, nitrofuritonin and co-amoxiclav
memory more confused and confused speech. Told not heart attack. what is this and how will it be medically dealt with
memory more confused and confused speech. Told not heart attack. what is this and how will it be medically dealt with
Brief Answer:
Brain imaging study needed.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns.
About neurologic symptoms related to memory and confused speech, there's need for brain imaging studies ( CT scan or better MRI) in order to evaluate possible brain damage related to your cardiac and infection condition.
These brain lesions could be stroke (hemorrhage or ischemic) and brain infection ( cerebritis, meningitis,brain abscess).
If strong doubts about brain infection evaluated clinically by a Neurologist, a lumbar puncture with cerebrospinal fluid drawing and testing is needed.
To prevent further possible brain damage atrial fibrillation should be controlled and warfarin should be continued with regards to INR levels.
Hope this helps. I remain at your disposal for further questions and clarifications.
Best regards.
Brain imaging study needed.
Detailed Answer:
Hello and thanks for using HCM.
I have read your query and understand your concerns.
About neurologic symptoms related to memory and confused speech, there's need for brain imaging studies ( CT scan or better MRI) in order to evaluate possible brain damage related to your cardiac and infection condition.
These brain lesions could be stroke (hemorrhage or ischemic) and brain infection ( cerebritis, meningitis,brain abscess).
If strong doubts about brain infection evaluated clinically by a Neurologist, a lumbar puncture with cerebrospinal fluid drawing and testing is needed.
To prevent further possible brain damage atrial fibrillation should be controlled and warfarin should be continued with regards to INR levels.
Hope this helps. I remain at your disposal for further questions and clarifications.
Best regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
Since contacting you a CT scan undertaken. Have ruled out injury-no comment on brain infection. Speech continues poor and now severe swallowing difficulties. Doctors say no Stroke or CVA and no heart attack. They say Do not resuscitate in his best interests despite his known requests for resuscitation. Arrhythmias now corrected and on inohep / heprin injections instead of warfarin. Could it be dementia related instead of a brain infection? For either issues what is the chances of getting back to previous state of health and abilities? Remains very weak, unable to move self and extra sleepy, more than before.
Thank you. Please note when giving star ratings unable to see the stars so go to home page to rate.
Thank you. Please note when giving star ratings unable to see the stars so go to home page to rate.
Brief Answer:
Difficulty swallowing could be related to brainstem lesions.
Detailed Answer:
Welcome back XXXXXXX
If brain infection, CVA, brain abscess are ruled out, then health issues you describe could be related to advancing of dementia.
Swallowing difficulties are related to brainstem lesions, and CT scan is not the best imaging tool to evaluate small brain lesions.
If it is possible, a brain MRI could give more and accurate information if there are brain lesions that are responsible for the symptoms or not.
Chances of improvement are evaluable only after the correct diagnosis and MRI is needed for this purpose.
Hope I helped you.
Take care.
Difficulty swallowing could be related to brainstem lesions.
Detailed Answer:
Welcome back XXXXXXX
If brain infection, CVA, brain abscess are ruled out, then health issues you describe could be related to advancing of dementia.
Swallowing difficulties are related to brainstem lesions, and CT scan is not the best imaging tool to evaluate small brain lesions.
If it is possible, a brain MRI could give more and accurate information if there are brain lesions that are responsible for the symptoms or not.
Chances of improvement are evaluable only after the correct diagnosis and MRI is needed for this purpose.
Hope I helped you.
Take care.
Above answer was peer-reviewed by :
Dr. Prasad
The doctor in charge of the case asked about resuscitation and has given no medical reason for this but says he should eventually be well enough to return home. I said to resuscitate based on his wishes and the quality of life he had previously to admission to hospital. Dehydration and anthemia's elevated did not seem a reason to deny resuscitation. However, the doctor said the consultant can override this so she would escalate it higher up.
What are the implications of brain lesions? other than swallowing difficulties?
Thank you for aprompt reply as the matter is quite important to immediate decisions. Knowledge is important to understand what is going on. Thank you for sharing your knowledge and expertise.
What are the implications of brain lesions? other than swallowing difficulties?
Thank you for aprompt reply as the matter is quite important to immediate decisions. Knowledge is important to understand what is going on. Thank you for sharing your knowledge and expertise.
Brief Answer:
Brain damage could be at celular level.
Detailed Answer:
Hi again XXXXXXX
Dehydration and arythmias are treatable and reversible causes, but these conditions can cause permanent brain damage by impairment of brain supply with blood and oxygen, affecting this way, almost all brain functions.
This kind of brain damage is irreversible and the patient usually ends in a vegetative state.
Furthermore, there could not be evidence of lesions by brain imaging studies, the damage is located at celular levels.
The decision to resuscitate or not should be taken upon this ( vegetative state ) diagnosis and previous health issues should be considered as well.
There are available criteria to evaluate the vegetative state diagnosis, but this needs qualified medical expertise.
Hope this helps. Best regards.
Brain damage could be at celular level.
Detailed Answer:
Hi again XXXXXXX
Dehydration and arythmias are treatable and reversible causes, but these conditions can cause permanent brain damage by impairment of brain supply with blood and oxygen, affecting this way, almost all brain functions.
This kind of brain damage is irreversible and the patient usually ends in a vegetative state.
Furthermore, there could not be evidence of lesions by brain imaging studies, the damage is located at celular levels.
The decision to resuscitate or not should be taken upon this ( vegetative state ) diagnosis and previous health issues should be considered as well.
There are available criteria to evaluate the vegetative state diagnosis, but this needs qualified medical expertise.
Hope this helps. Best regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
Hi, I need to be clear based on your information.
based on the fact of swallowing difficulties, still on drip, heart monitoring box in place, no CVA or heart attack. should I look at not perusing MRI scan or looking for lesions or brain infections. Are you suggesting it appears more cellular and therefore not in best interests to look at resuscitation. He is speaking and understanding what is said but not eating and drinking well and is on pureed diet. Please clarify as no medical input from hospital which I should have according to all official sources. Your input is so valuable to meet best interests. Many thanks
based on the fact of swallowing difficulties, still on drip, heart monitoring box in place, no CVA or heart attack. should I look at not perusing MRI scan or looking for lesions or brain infections. Are you suggesting it appears more cellular and therefore not in best interests to look at resuscitation. He is speaking and understanding what is said but not eating and drinking well and is on pureed diet. Please clarify as no medical input from hospital which I should have according to all official sources. Your input is so valuable to meet best interests. Many thanks
Brief Answer:
MRI is indispensable.
Detailed Answer:
Welcome back XXXXXXX
A brain MRI is the best imaging tool to evaluate any structural brain damage or lesion.
If MRI results negative ( or there are no structural damages of brain that justify neurologic symptoms), then the brain dysfunction, or neurologic symptoms are most probably related to celular levels damage.
So, in my opinion, a brain MRI is of paramount value at this point.
Hope I've been understandable.
Take care.
MRI is indispensable.
Detailed Answer:
Welcome back XXXXXXX
A brain MRI is the best imaging tool to evaluate any structural brain damage or lesion.
If MRI results negative ( or there are no structural damages of brain that justify neurologic symptoms), then the brain dysfunction, or neurologic symptoms are most probably related to celular levels damage.
So, in my opinion, a brain MRI is of paramount value at this point.
Hope I've been understandable.
Take care.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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