Suggest treatment for short memory loss

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Posted on Fri, 1 Jul 2016 in Brain and Spine
Question: Hello Doctor,

My dad went into hospital 4 days ago due to short memory loss. We started to notice issues 6 days ago.
Things we noticed:
-     Cannot remember what he did the day before or even an hour ago
-     Does not remember who visited him in hospital or which hospital he is in
-     Keeps on repeating the same questions. He is confused and has severe headaches.
-     He can remember our names, DOB, address & occupation. Long-term memory is very good in my opinion
-     He is emotional and personality is different

Things to note:
-     The doctors think it is viral encephalitis (herpes)
-     They have been treating him with 1g Aciclovir twice a day since 4 days ago (Since admitted to hospital)
-     CT scan came back clear
-     MRI came back with inflammation of brain in two areas (They made it sound like it was minor inflammation). I am unable to get a copy.
-     They performed ‘spinal tap’ 2 days ago. It did not come back positive for encephalitis. They said there’s still a good chance that its viral encephalitis.
-     Appears to have a slightly stiff neck but did not have a fever. I know these are symptoms on encephalitis.
-     He was moved to another hospital today and they performed Electroencephalography (EEG). They said it would take a couple days to get the results back.
-     They performed a neurological exam (12 or so tests) in front of me today. He seemed to pass them all okay.

My dad is 57 years old… Previously was admitted to hospital 6 months ago for slight memory problems (nowhere near as severe as this time) but more so because he couldn’t speak properly and felt dizzy. He felt like the right side of his face and right arm was paralysed. We thought he had a stroke but the doctors ran CT\MRI scans and all came back clear. There was no conclusive answer, possibly micro stroke.

Doctor, I’ve spent over 5hrs with my dad today and his condition is deteriorating and so is his memory. We are coming into day 5 and I don’t know what else we can do. He now has a memory span of 1-2minutes and getting very emotional and crying. Constantly repeating himself and not understanding why he is in hospital. Is there anything else you can suggest? Other possibilities? Perhaps there is better medication\treatment than Aciclovir?

Your help would be much appreciated.
Thank you for your time
doctor
Answered by Dr. Ishu Bishnoi 29 minutes later
Brief Answer:
Consultation

Detailed Answer:
Hi XXXXXXX thanks for asking from HCM.


I can understand your concern. Before reaching unto some conclusion, I need to know about
Presence of Diabetes Mellitus
Presence of Dementia in family
What is the status of his electrolytes

If you can provide me answers of above question, It would be very helpful.

Sudden memory deterioration is not always due to brain causes. It could be due to

: Delirium - It is state of confusion, altered behaviour, memory loss due to metabolic derangement in body. It can occur due to
; electrolyte imbalance like sodium/potassium/calcium
; acidosis or alkalosis
; presence of infection in body like sepsis
; diabetic ketoacidosis or hyperosmolar coma

: Metabolic encephalopathy - It is indirect damage of brain due to accumulation of toxins in body. It can be caused by
; kidney damage or failure
; liver damage or failure
; alcohol (Wernicke-Korsakoff syndrome)
; poor nutrition

: Alzheimer's disease - Rarely acute onset can occur if there is family history.

: Stroke - Ischemic stroke can cause. As there is history of micro stroke or transient ischemic stroke, it might be full stroke this time. You can discuss it with doctors.

The doctor might advise USG doppler study of neck vessels to know about there status.

I have provided you a list of causes other than viral encephalitis. If you can provide me MRI report, it would help us in relating findings with stroke or encephalitis. The doctor can ask for quantification of intrathecal antibodies: For evidence of CNS antibody response to confirm diagnosis.


Ask your doctor to look for other causes also. At least ruling out all those causes will narrowing diagnosis to encephalitis.

Treatment can be changed only after confirmation of diagnosis. Other than acyclovir, Famciclovir can be given for herpes encephalitis.

Hope it will help you. Thanks, take care.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Ishu Bishnoi

Neurologist, Surgical

Practicing since :2007

Answered : 830 Questions

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