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Dr. Andrew Rynne

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What causes sudden onset of impaired brain function?

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Dr. Raju A.T

General & Family Physician

Practicing since :2008

Answered : 3849 Questions

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Posted on Mon, 11 Aug 2014 in Mental Health
Question: My daughter went to bed a 55 year old married woman, doing all her regular household tasks, in October, 2012, and woke up the next morning wet, like a 1 year old child, with no seeming communication between her brain and her bladder or bowels. Being that her husband is somewhat disabled, himself, after about the 3rd day of going to their house to get her cleaned up, I just brought her home with me, and I have been caring for her in my home ever since. She is fairly easy to care for. But her brain is just not working right. She has no idea when or if she has to go to the bathroom, or even if she's "gone" when she's on the toilet. She gets obsessive thoughts about "having to go outside", and is content to just sit on the porch, looking at the newspaper or a book. She is able to read a little bit sometimes. I have a child's Scrabble Game that just has a person match letters. And sometimes she can match some, and other times not. If I ask her to spell a word, sometimes she can, and sometimes not.
At this point she is not wandering away, thank God. But when I have to give her a bath and shampoo, she gets very resistant, because she "has to go outside!" The past 2 weeks, I have had my older daughter come over and help me with this.
She has had Bipolar Disorder for many years, and is under the regular care of a very good Psychiatrist. He has managed to keep it fairly well under control. But at this point, he has no idea what has happened to her. She has been to 2 Neurologists, and to the Neurology Clinic at Froedtert Hospital. None of them has a clue as to what has happened to her. In some ways it's somewhat like a stroke. But she has had MRIs, and they don't seem to show evidence of a stroke. The doctors have said that it kind of resembles Alzheimers or Dementia, except for it coming on so suddenly--overnight. And, whether this has anything to do with it, or not, I don't know--but at about the same time, she developed an infection in both her eyes. She has a kind of gooky white stuff that comes out of them every day. Her regular Eye Doctor prescribed some eye drops, and had me wash her eyes twice a day with Baby Shampoo. This has helped it not to get any worse. But as soon as the eye drops are gone, it's just as bad as ever. So, we took her to Dr. XXXXXXX Knight, another Eye Doctor. He prescribed an Antibiotic Ointment to put on her eyes, and continue to wash with the Baby Shampoo. Then he suggested we take her to the Mayo Clinic. I have no idea about your charges or arrangements, or if her Medical Insurance would cover anything or what. I'm a widow on Social Security myself. And she and her husband are both on Social Security Disability. All three of us have United Health Care for our Insurance. Do you have any suggestions or ideas?
Thank you very much for any help you can offer. Is there a charge for this letter and response? If so, what is it? Please let me know. Thank you.
Sincerely,
XXXXXXX
XXXXXX
doctor
Answered by Dr. Raju A.T 28 hours later
Brief Answer:
Please attach the reports

Detailed Answer:
Hi,

Thanks for your query.

Sorry for the delayed response,

The symptoms though resemble to ones seen in Alzheimer's, I do not think that is the diagnosis here.

Yes, it does seem like a stroke in a smaller part of the cortex of the brain. the part of the brain which controls the functions of the bladder which are lost might have faced ischemia.

Please attach the MRI reports here, I shall have a look and provide you a basic idea on what it is and how to proceed hereon.

Also please do mention what insurances are there to cover your daughters health and which area do you reside in. I shall suggest you a neurologist who can treat such conditions, who has good experience and can accept the insurance you carry.

Waiting for your response,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Raju A.T 10 hours later
Dear Dr. XXXXXXX
Thank you very much for your prompt response.
I will try to get hold of her MRI reports to send to you as soon as possible.
She has United Health Care Insurance.
We live in the XXXXXXX WI area.

Thank you very much for any help you can give!

Sincerely, XXXXXXX

doctor
Answered by Dr. Raju A.T 7 hours later
Brief Answer:
Will wait for the MRI scan report

Detailed Answer:
Hi,

Thanks for writing back.

Below I have provided details of the doctors who specialize in such conditions and also accept the insurance you mentioned.

Dr. Bhupendra O. Khatri, MD
Neurology
3237 S 16th St, XXXXXXX WI 53215
Center for Neurological Disorders
(414) 769-4040 (Office)

Dr. XXXXXXX Woo, MD
Neurology
9200 W Wisconsin Ave, XXXXXXX WI 53226
(414) 805-5200 (Office)

Dr. Sophos G. Geroulis, MD
Neurology,
W 180 N800 Town Hall Rd, Menomonee Falls, WI 53051
Froedtert Health Medical Group
(262) 532-3250 (Office)

Wish you good health.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Raju A.T 19 hours later
Dear Dr. XXXXXXX
Thank you again for your kind and prompt response. Thank you for the list of doctors who may be able to help my beloved daughter.
I am in the process of trying to get hold of her MRI report. Over the weekend, of course, it was not possible.
But I will try today, and let you know.
Thank you very much.

Sincerely, XXXXXXX
doctor
Answered by Dr. Raju A.T 6 hours later
Brief Answer:
Will wait

Detailed Answer:
Hi again,

You are welcome. I am here to help you.

I shall wait for the MRI.

Wish you good health.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Raju A.T 39 minutes later
Hi again,
I was able to pick up the MRI disc. Would you please give me your exact address to send it to? If so, I will mail it by Priority Mail tomorrow.
Thank you again very much for the list of doctors. We will probably go with Dr. XXXXXXX Woo, as he is about the closest to us.

Sincerely, XXXXXXX
doctor
Answered by Dr. Raju A.T 2 hours later
Brief Answer:
Upload the scans if possible

Detailed Answer:
Hi,

Please upload the scans if possible.

If they are not in image format. Do upload a scan of the typed impression report.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Raju A.T 2 days later
Hi Dr. XXXXXXX
My daughter XXXXXXX uploaded the MRI of my other daughter, XXXXXXX Schade, to you on Tuesday evening, July 15. Did you get it?
Thank you.
Sincerely, XXXXXXX
doctor
Answered by Dr. Raju A.T 20 hours later
Brief Answer:
Please upload again

Detailed Answer:
Hi again,

No, I did not receive the attachment.

Please upload it again on the right side of the page or mail it to YYYY@YYYY to my attention.

Regards,




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Raju A.T 21 hours later
Hi Dr. XXXXXXX
I was sorry to hear that you did not receive the attachment that my daughter XXXXXXX sent you a few days ago.
She is out of town for the weekend, but will be happy to come over and try again when she gets back.
Otherwise, as I have said, I would be very happy to just mail you the disc by Priority Mail, if you would give me your exact address to mail it to.
Sincerely, XXXXXXX
doctor
Answered by Dr. Raju A.T 10 hours later
Brief Answer:
I shall wait

Detailed Answer:
Hi,

My office location is in XXXXXXX

Healthcaremagic.com room no 272
14, Old Madras Road, Bhattrahalli,
Krishnaraja Puram, XXXXXXX XXXXXXX 560049 XXXXXXX

If possible do send and for the worse I may not be able to send it back to you.

Hence, I shall wait until you send the scans by uploading them here.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Raju A.T 12 hours later
Dear Dr XXXXXXX
Thank you for your kind response. Unfortunately, I am not so knowledgeable about computers as to know how to upload the MRI disc myself. And my daughter, who does know more about such things, is out of town this weekend. She did try, but apparently was unsuccessful the first time.
I will ask her again when she returns. If she is unsuccessful again, I will try to mail the disc to you in XXXXXXX It's alright if you are not able to mail it back. I think we could get another copy from the place where she had the MRI done, if it would be necessary--like to show it to Dr. Woo, whom you had recommended.
Thank you again for your help so far!
Sincerely, XXXXXXX
doctor
Answered by Dr. Raju A.T 4 hours later
Brief Answer:
I shall wait

Detailed Answer:
Hi,

I shall wait for the report.

I will for sure help you in combating this problem.

regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Raju A.T 16 hours later
Hi,
Thank you for your response.
I am waiting to hear from my daughter. She should be home by now. But she does have to go to work today.
I will let you know what she plans to do.
Sincerely, XXXXXXX
doctor
Answered by Dr. Raju A.T 12 hours later
Brief Answer:
Sure

Detailed Answer:
I shall wait.

regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Raju A.T 1 hour later
Hi Dr. Raju-
I uploaded some more scans. Hopefully you will receive them.
Sincerely, XXXXXXX
doctor
Answered by Dr. Raju A.T 23 hours later
Brief Answer:
Scan report receieved

Detailed Answer:
Hi,

Thanks for the report.

I noticed that the only finding I could make out in the scans is generalized cerebral atrophy. This is usually seen in old age due to age related degeneration of brain. Well, there are many other conditions wherein brain atrophy can be seen in adults too. The psychiatric problems she has can be seen in the atrophy the scan shows, most of times these symptoms will be associated with many other motor symptoms too.

I would like to know some more details on her symptoms to arrive at most probable diagnosis.

Does she any movement disorder ?
Are there any involuntary movement in her ?
Does she have strength to move around normally ?
Does she have stiffness in the muscles ?
Please explain her communication skills.

Waiting for your reply,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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