Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Speech Disorder, Bed-wetting, Fear, Absent Mindedness And Confusion?
Question: was under treatment for alcoholism and depression since last 1 year. was good after initial 3 months for the next 3-4 months. after that he drank few days while on desulfiram . after few days he got severe reaction. he was very much fearful. reaction was gone after few days.
after some time (dont remember how many weeks after this incident), he got confusion. we didnt knew it is confusion. he is introvert so we didn't knew his mind. 1 month back he got severe delirium and agitation. and when we taken him to psychiatrist , then we came to know it was delirium all these days. then he was given medicines mentioned in current. but after 25 days also his confusion did not improved.
his SGOT,SGPT and CT scan were normal. we dont know what is the reason. before this, he was taking baclofen 10,stablon 12.5 stressnil 0.5 and amizep 12.5mg 4 tablets day. but at the later phase he reduced his doses of baclofen and stablon to 2 and then 1. may be it was the reason. now its been 25 days on current medication.
what can be the other causes for his confusion.
his symptoms are -
1. not able to speak and understand clearly.
2. also doing bed-wetting nowadays
3. having illogical and out of place fears in his mind
4. says things which are weird and out of place.
5.remember and says thing after taking lot of time to think
6. may go outside in whatever clothes he was wearing. so as per your understanding
, what may be other causes which may cause confusion?
most of the times he keeps looking at the same place continuously and did not blink for a seriously long time.
i haven't counted but once atleast around 2 minutes he did not blinked then i started doing something else so could not see when he blinked
after some time (dont remember how many weeks after this incident), he got confusion. we didnt knew it is confusion. he is introvert so we didn't knew his mind. 1 month back he got severe delirium and agitation. and when we taken him to psychiatrist , then we came to know it was delirium all these days. then he was given medicines mentioned in current. but after 25 days also his confusion did not improved.
his SGOT,SGPT and CT scan were normal. we dont know what is the reason. before this, he was taking baclofen 10,stablon 12.5 stressnil 0.5 and amizep 12.5mg 4 tablets day. but at the later phase he reduced his doses of baclofen and stablon to 2 and then 1. may be it was the reason. now its been 25 days on current medication.
what can be the other causes for his confusion.
his symptoms are -
1. not able to speak and understand clearly.
2. also doing bed-wetting nowadays
3. having illogical and out of place fears in his mind
4. says things which are weird and out of place.
5.remember and says thing after taking lot of time to think
6. may go outside in whatever clothes he was wearing. so as per your understanding
, what may be other causes which may cause confusion?
most of the times he keeps looking at the same place continuously and did not blink for a seriously long time.
i haven't counted but once atleast around 2 minutes he did not blinked then i started doing something else so could not see when he blinked
Brief Answer:
It could be due to late wernicke encepahalopathy
Detailed Answer:
Dear XXXXXXX
Thanks again for posting at Healthcaremagic.
I read your query and understand your concerns.
Since he has not recovered the most plausible cause for his confusion is alcohol withdrawal syndrome resulting in wernickes encepahalopathy. This is the most likely cause as when we interacted around two months back he was not receiving any thiamine and deficiency of thiamine is most likely cause for this encephalopathy.
The second possible reason is alcohol related dementia as many of the current features indicating toward dementia although we need MRI report to confirm it.
Considering his current symptoms I feel MRI brain with dementia protocol is need of hour. This will reveal the true damage to the brain in understandable manner.
I hope this helps you.
If you have more questions feel free to write back to me.
Thanks and regards.
It could be due to late wernicke encepahalopathy
Detailed Answer:
Dear XXXXXXX
Thanks again for posting at Healthcaremagic.
I read your query and understand your concerns.
Since he has not recovered the most plausible cause for his confusion is alcohol withdrawal syndrome resulting in wernickes encepahalopathy. This is the most likely cause as when we interacted around two months back he was not receiving any thiamine and deficiency of thiamine is most likely cause for this encephalopathy.
The second possible reason is alcohol related dementia as many of the current features indicating toward dementia although we need MRI report to confirm it.
Considering his current symptoms I feel MRI brain with dementia protocol is need of hour. This will reveal the true damage to the brain in understandable manner.
I hope this helps you.
If you have more questions feel free to write back to me.
Thanks and regards.
Above answer was peer-reviewed by :
Dr. Prasad
thanks for replying and remembering the case.
he is taking Benfotiamine (in felicita tab) which is derivative of thiamine. are there differences in effectiveness of both?
his CT scan came normal. so cant CT scan detect dementia?
can we exclude other causes like some infections or other causes based on my information?
he is taking Benfotiamine (in felicita tab) which is derivative of thiamine. are there differences in effectiveness of both?
his CT scan came normal. so cant CT scan detect dementia?
can we exclude other causes like some infections or other causes based on my information?
Brief Answer:
CT scan have limitations
Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.
Although there is no difference between efficacy of thiamine and benfothiamine but sometime a person with alcoholic develop complications despite best effort of treating healthcare professional. In other words the complications are inevitable despite the best treatment. His current pattern of confusion largely indicates toward alcohol related pathology and do not indicate anything related to infections as there was no fever at any moment of time.
Regarding CT, I do not think it is useful in identifying alcohol related dementia. MRI is better method or only way to determine alcohol related dementia lesions.
I hope this helps you further.
Thanks and regards.
CT scan have limitations
Detailed Answer:
Dear XXXXXXX
Thanks for reverting back to me.
Although there is no difference between efficacy of thiamine and benfothiamine but sometime a person with alcoholic develop complications despite best effort of treating healthcare professional. In other words the complications are inevitable despite the best treatment. His current pattern of confusion largely indicates toward alcohol related pathology and do not indicate anything related to infections as there was no fever at any moment of time.
Regarding CT, I do not think it is useful in identifying alcohol related dementia. MRI is better method or only way to determine alcohol related dementia lesions.
I hope this helps you further.
Thanks and regards.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
