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Suggest Treatment For Confusion, Memory Loss And Sodium Deficiency While Having Glandular TB

Posted on Wed, 13 Jan 2016

Question: Hello sir.My mother is 70 years old. She takes BP medicines regularly alongwith asthama inhaler everyday. Recently she has been diagnosed with glandular TB. So she had to take medicines as follows-- Macox Plus-600 one tab/ combutol-600 two tabs/ macrozide-1000 two tabs daily for the last four and half months. For the last one month she has developed confusion and memory loss severely along with sodium deficiency. Although sodium level has been raised from 123 to 132 after taking Resodim-15, there is no change in confusion and memory loss. So we had stopped the above TB medicines since one month. But no improvement is found. She is very hyperactive physically and never sits for 5 minutes constantly anywhere which is found now a days. From early morning to evening she moves throughout the house and does something like throwing water here and there, putting things in wrong places, talking about something which has never happened etc. Kindly help.

Answered by Dr. Sudhir Kumar (9 hours later)

Brief Answer:
Need to determine the cause of her symptoms.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your mother's symptoms and she seems to be suffering from cognitive decline. We can not call it dementia, as it is of short duration (symptoms should progress for at least six months to be called as dementia).

First of all we need to determine the cause of her symptoms. The likely causes are:

1. Low sodium (hyponatremia)- Low sodium can cause confusion, restlessness, agitation, etc. However, once the sodium is corrected to a level of 135 or more, symptoms should subside.

2. Drug induced- Anti TB drug isoniazid can cause confusion, but she is already off TB drugs now.

3. Brain disease such as infarct (lack of blood supply to brain) or spread of TB to brain- for this, we need to do MRI brain with contrast. If not done, please get it done. If done, please upload the report.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist

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

Follow up: Dr. Sudhir Kumar (1 hour later)

Thank u Sir. So far as brain TB is concerned, I would like to intimate the following points--
1. she has developed the symptoms while taking TB medicines regularly. After seeing the symptoms we stopped the TB drugs.
2. Is there any medicine to treat brain TB and to treat lack of blood supply to brain?

Kindly intimate Sir.

Answered by Dr. Sudhir Kumar (9 hours later)

Brief Answer:
Yes, there are medicines.

Detailed Answer:
Thank you for getting back.

Yes, there are medicines to treat brain TB and lack of blood flow to brain.

Please get back with the MRI brain report.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

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

Follow up: Dr. Sudhir Kumar (2 hours later)

Sir, she has left leg fracture in the neck femur region and after surgery she had prosthetic fitting in that area. So in MRI the magnet may pull the prosthetic of the leg. Can we opt for city scan? Kinldy tell me.

Sir, please save my queries so that I can again pay and ask 3 questions referring to this query. Please save the query.

Answered by Dr. Sudhir Kumar (1 hour later)

Brief Answer:
CT scan would be safer.

Detailed Answer:
Thank you for getting back.

I agree with you that in her case, doing a CT scan would be safer. However, if needed, MRI can also be done, as it does not affect the prosthesis in a bone much.

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Best wishes,

Dr Sudhir Kumar MD DM (Neurology)

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