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Dr. Chip
Dr. Chip, Board Certified Physician
Category: Medical
Satisfied Customers: 36077
Experience:  20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.
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My elderly mother (91 years old) was very well on Sunday morning,

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My elderly mother (91 years old) was very well on Sunday morning, with her brain working well as usual. Her short memory has not been good and had deteriorated for the last year, but her judgement impeccable and she is jolly with her existing medication :She has been on antidepressants seropran 10 mg in the morning and 20 mg at night, amipritrivine 10 mg 3 times daily , Ebixa 10 mg once daily, and Xanax 1/2 tablet 0.25 at night before sleeping. She also takes medication for her high blood pressure and heart ( rythmonol 75 mg twice daily, kozar 50 mg, lopresor 1/4 tablet of 100 mg, kozar 50 mg and Plavix 75 mg every second day).

on Sunday afternoon all of a sudden she stopped recognising the lady live-in carer who looks after her for a year and a half, got very agitated, talked gibberish and had a very bad sleepless night. This continued on Monday, the carer asked my brother to come over to my mother's house, , he arrived by 2 pm on Monday, my mother did not recognise him, tried to hit him with her stick, talked without making sense, and in general continued to behave like a mad woman, focusing her eyes in the void, and murmuring without anybody being able to understand anything.
We rang the neurologist-psychiatrist who looks after her and he suggested we stop all seropran, amipritrivine and give her Seroquel, 25 mg one morning and one night, and Xanax 0.25 one tablet before going to bed. She started calming down but still in a mad state. I, her daughter, whom she adores, arrived from London at her house on Tuesday morning. ( she lives in Greece). She gave me a big hug and cried, but in a minute, she forgot who I was. On Tuesday afternoon she had 30 min interval during which her behaviour was completely normal suddenly, just after she woke up from afternoon siesta, around 4 pm. She was extremely happy to see me but she did not remember that I had arrived in the morning. Then, back again to her mad state, but much calmer than prior to taking seroquel. We took her to the neurologist on Tuesday afternoon to examine her. He thinks she will eventually return to normal and suggested we continue with seroquel 2 tablets daily, each 25 mg, and Xanax. she continued in her mad state today Wednesday, she was anxious and failed to sleep for afternoon siesta today. She had moments of normality, during which she embraced me and kissed me and cried, and two minutes later she cursed at me. She went to bed at 9 pm, then, she woke up 30 min later, came alone to our sitting room, fully normal, very excited to see me, chatted to me normally, but she forgot that I have been at her house since Tuesday morning.she thought I had just arrived. I rang my 28 year old son who she adores, she spoke to him very fondly, the good state lasted 30 min and then she went back to her mad state, murmuring to herself, a bit aggressive, and not recognising us.

I suspect a stroke may have happened that affected her brain, but the neurologist who saw her said it is not a stroke. She walks, eats, and can speak.

What can cause such a sudden dementia? Could it be blood vessels In her brain suddenly broken or blocked? In 9/2011 a scan for her head showed she had passed a small stroke and that blood circulation in her head was not great.

What else can we do, if anything apart from seroquel? Shall I take her to a second psychiatrist for a second opinion? Will she return to normal? It is very strange that she has had two 30 min intervals of very normal behaviour and then lost again in dementia. How can you explain this?
Hi--just to be sure here there doesn't seem to be any change in her vision, her balance, her arm and leg feeling and strength, and no tremor?
Customer: replied 4 years ago.
Nothing at all, her vision seems fine, she read subtitles on the tv in one of her" normal "intervals, she walked outside the house for 30 min today with the carer, and yesterday we walked for 30 min after visiting the doctor ( she walks with the carer daily for 60 min or more, very slowly but she enjoys it and does it daily under normal circumstances) , her arms and legs are normal, she lifts her hands trying to reach something in her dream state, seems quite strong, she stands up unaided suddenly, while in her lost state, as she may think of something incomprehensible to us, and she has no tremor.
OK Raymond--was she checked for any infections, especially a bladder infection?
Customer: replied 4 years ago.
No, she was not checked for any infection, including bladder infections. The neurologist did not mention it.
OK Raymond--and we can continue after this if you'd like. I have seen this kind of thing happen many times in elderly females and it turned out to be a bladder infection that wasn't even suspected, so the first thing I would do is get a urinalysis and treat the infection if it were there. Very simple way to solve this whole problem. That said, although I don't think this is a stroke, I'd still get an MRI of her brain. Thirdly--I think she may be overmedicated here and I'm not at all sure about the Seroquel, so if this does clear up I think she should get a second psychiatric opinion
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