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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 65006
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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Dear Doctor, I am just enquiring about a condition

Resolved Question:

Dear Doctor,


I am just enquiring about a chronic condition that I have had for 6 years and I would like to know your opinion on whether my assumptions are plausible. I will start with a brief history of the illness along with the medical tests and healthcare that I have previously received.

Around 7 years ago (I was 18 at the time) , whilst away with friends on holiday, I woke up after a night of heavy drinking with diarrhoea, vomiting and a complete change in mood and cognition: which at the time was both traumatic and disorientation. Instantly, I intuitively felt disconnected, unable to express my thoughts and a sense of major cognitive impairment (at the time I just kept saying "my head doesn't work"). For the following 3 or 4 day I had continuing gastric distress however vomiting stopped after around 2 day (approximately from my recollection). Once the trip was over I continued to have cognitive symptoms such as a poor attention span, but I also had a sense of disconnect, sadness and fear. Since this incident I have not been myself at all. I constantly find it difficult to plan ahead, to stay focused to express my thoughts and feelings, to find words to remember information etc. this has lead to me not being able to continue education or to keep a job (due to me quitting).

I initially saw a psychologist who believed I have depression and who subsequently counselled me for 2 years whilst consulting with a psychiatrist who prescribed me with ssris namely: fluoxetine 20mg and citolopram 20mg. This intervention did not work however and so I discontinued treatment. Around the same time as seeing the psychologist I had an MRI and an EEG which presented normal readings.

After 2 years of isolation, sleeping in and becoming depressed my parents decided to persuade me to go to university. Throughout this time I found it extremely difficult to understand the concepts of the course, I was always fatigued in mornings and I found it difficult to socialise as I couldn't think properly and coherently. In the end I dropped out of university in my final year. Throughout my time at university, I saw a GP who occasionally prescribe Diazepam and sleep medication.

Since then I have struggle to keep a normal routine but have been incredibly determined to get better to no avail. I still believe I have brain damage. I recently saw a psychiatrist who also prescribed a variety of anti depressants which worsened my symptoms and so referred me to a neuropsychologist who has yet to give me a full neuropsychological assessment. The neuropsychologist is looking to see whether I may have sustained a brain injury due to viral encephalitis. The pathology of viral encephalitis has never been ascertained.

My symptoms include.

Having a constant awareness of my thought processes
Difficultly digesting information
Poor attention span
Inability to enjoy task due to difficulty carry them out
Difficulty with mathematical and logical problems
Occasion headaches
Difficulty structuring sentences
Poor sleep quality and often chronic bouts of insomnia
Anxiety due to fear of symptoms
Difficulty in following conversation or television program
And many more..

Due to the complex nature of this illness and the lack of a proper clinical setting I am not looking for a diagnosis. I would however like to know your opinion on whether it is possible to acquire a brain injury after drinking excessive alcohol, what initial symptoms of viral encephalitis present and whether it is more like that excess alcohol could trigger a major depressive episode.

Thanks for you consideration,


Jacques Malecaut
Submitted: 3 years ago.
Category: Medical
Expert:  DrRussMD replied 3 years ago.
Hello
Drinking excessive alcohol once or twice is not going to cause permanent brain damage.
In general viral enchephalitis resolves, but can leave some residual damage....but is usually manifest in a way that a neurologist would be able to detect.
Have you seen a neurologist?
Customer: replied 3 years ago.
I had initial brain EEG and MRI a few months after the event which came back completely normal. I am now in the process of receiving an appointment for a neuropsychological assessment to measure my cognitive abilities. Is it still possible that encephalitis would not show up on a scan so long after the event?
Expert:  DrRussMD replied 3 years ago.
Yes
You can have subtle effects which persist.
That would be more likely to show up on psychological testing.

Use reply to let me know if you have further questions. [click reply to expert].
Please to not forget a positive rating.
Customer: replied 3 years ago.
Firstly I accidentally clicked poor service as opposed to excellent service so if there is a way of rectifying that then I will. The neuropsychologist will be looking to see if there are any subtle difficulties in my cognition and once that assessment has been determined I will have a clearer picture of my illness.

Lastly I would just like to know how the usual symptoms of viral encephalitis present (especially the physical)
Expert:  DrRussMD replied 3 years ago.
You can click a positive on this post to reverse your error.

After it is over, there are no standard symptoms.

If you have it acutely, head pain, fever, delerium, even death.


Use reply to let me know if you have further questions. [click reply to expert].
Please to not forget a positive rating.
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