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What Causes Sudden Onset Of Memory Problem, Hallucinations And Fainting?
Question: She had severe leg ache since December,which Doctor diagnosed as restless leg syndrome and eventually she had psychological problems like hallucinations, fear and memory loss.On 1St of March she had been to temple and suddenly became unconscious on 2ND of March.She now just open her eyes otherwise has been bed ridden since 2ND of March.Pls suggest the best possible cure for her.
Brief Answer:
IVIG may be tried as last resort.
Detailed Answer:
Hi Ms XXXXXXX
Thank you for sending the clinical details and a few laboratory reports.
It is unfortunate that she had a rapidly progressive neurological illness resulting in bed bound state within three months of symptom onset.
The clinical picture is suggestive of CJD (Creutzfeldt XXXXXXX Disease). CJD worsens rapidly and there is no cure for it. CASPR2 antibody may be positive in patients with CJD.
CASPR2 antibody subtype of VGKC is also positive in patients with autoimmune encephalitis such as limbic encephalitis. In these patients, immunotherapy with methylprednisolone (Solumedrol) or IVIG (intravenous immunoglobulins) may be useful.
So, as a last hope, IVIG may be tried. IVIG is safe, and for a 85 kg person, a dose of 170 grams (total) would be needed (given over five days). This would cost about Rs 6 lakhs at MRP (direct purchase from Pharma company may come at discount).
If you have the MRI, EEG and CSF reports, please upload them.
Please get back if you have any follow-up queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist.
IVIG may be tried as last resort.
Detailed Answer:
Hi Ms XXXXXXX
Thank you for sending the clinical details and a few laboratory reports.
It is unfortunate that she had a rapidly progressive neurological illness resulting in bed bound state within three months of symptom onset.
The clinical picture is suggestive of CJD (Creutzfeldt XXXXXXX Disease). CJD worsens rapidly and there is no cure for it. CASPR2 antibody may be positive in patients with CJD.
CASPR2 antibody subtype of VGKC is also positive in patients with autoimmune encephalitis such as limbic encephalitis. In these patients, immunotherapy with methylprednisolone (Solumedrol) or IVIG (intravenous immunoglobulins) may be useful.
So, as a last hope, IVIG may be tried. IVIG is safe, and for a 85 kg person, a dose of 170 grams (total) would be needed (given over five days). This would cost about Rs 6 lakhs at MRP (direct purchase from Pharma company may come at discount).
If you have the MRI, EEG and CSF reports, please upload them.
Please get back if you have any follow-up queries.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Sir,
Thank you for giving us timely reply.I am sending you all the reports on your mail, Pls tell us are we giving her the correct medication and we would like to inform you that doctor here had given her brain stimulators for 5 days, and during that time she responded well but her blood sugar did increase around 250-300. Would IVIG injections would be safer for her and the only remedy for us.Pls guide us.
Thank you for giving us timely reply.I am sending you all the reports on your mail, Pls tell us are we giving her the correct medication and we would like to inform you that doctor here had given her brain stimulators for 5 days, and during that time she responded well but her blood sugar did increase around 250-300. Would IVIG injections would be safer for her and the only remedy for us.Pls guide us.
Brief Answer:
Reports have not yet been received.
Detailed Answer:
Thank you for getting back.
You can upload the reports here too.
IVIG is very safe and effective in autoimmune conditions such as limbic encephalitis. However, in CJD it will not help.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Reports have not yet been received.
Detailed Answer:
Thank you for getting back.
You can upload the reports here too.
IVIG is very safe and effective in autoimmune conditions such as limbic encephalitis. However, in CJD it will not help.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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