Patient Update Nov 23, 2007

A full week before admittance to the Epilepsy center at Henry Ford hospital, the Patient decided to discontinue prescribed 150mg of Lamictal -- only taking half and stopped taking Zyprexa. After the hospital visit, the doctors encouraged Patient to go back to taking the full 150mg dosage for seizure prevention. However, within a few days of taking ONLY Lamictal as prescribed, profound negative effects became obvious in Patient. Patient was struggling to maintain any type of focus: appeared to be in a total fog. Cognitive ability was extremely compromised. Patient was in constant motion wither going to sit or going to lay down, could not get comfortable, making 6 trips per hour to lay down. Patient could not understand easy questions and was feeling nausea, poor appetite, profound weakness being unable to get up from sitting position without assistance, poor posture, standing in place staring for extended periods of up to 10 minutes. It was so bad we were almost going to take patient to the hospital. On Nov. 21 Patient resumed taking Zyprexa prescribed dose and stopped Lamictal. Within 24 hours, Patient regained muscle strength, cognitive ability returned, nausea absent, appetite normal, 90% of excess sitting and standing absent. @48 hours emotions improved, cognitive speed improved, posture improved.


We should request Patient see a cardiologist for the orthostatic hypotension, and determine if current Psychiatrist can refer her to one. We have an appointment for Patient's B 12 levels and Thyroid to be tested. We would like to know Patient's histamine, copper, methylation, homocystene levels to specifically find vitamin deficiency and behavior subtyping. (There's a hospital outside of Chicago that treats patients based on these results).

We would like to know if there are any other specialized doctors that can be recommended for further testing or evaluation for underlying medical issue.

vitamin B12 deficiency

We are curious if there could be an underly medical condition with
dementia-like symptoms such as vitamin B12 deficiency.
(Patient's symptoms appear in bold font below. Symptoms are either
current or experienced at one point or another)

Neuropsychiatric Manifestations of Vitamin [B.sub.12] Deficiency:
Peripheral nervous system involvement.
Symmetric peripheral neuropathy, beginning with
symmetric parasthesias of the lower extremities,
can ascend to eventually involve the upper extremities;

hyporeflexia may be present; occasionally autonomic
neuropathy occurs, which can present as orthostatic hypotension.

Spinal cord involvement.
Dorsal column involvement: loss of position and vibration sense,
ataxia,  broad-based gait, and, occasionally, Lhermitte's sign.
Lateral column involvement: weakness and spasticity
(spastic paraparesis), urinary and fecal incontinence,
impotence, hyperreflexia, clonus, and
Babinski reflex may be present.
Subacute combined degeneration.
Spinal cord involvement and peripheral neuropathy.
Visual impairment.
Retrobulbar neuritis, optic atrophy, and pseudotumor cerebri.

Psychiatric manifestations.
Dementia, hallucinations, 
frank ("megaloblastic madness"),
paranoia, depression, violent behavior, and 
change in personality

Above information taken from
http://findarticles.com/p/articles/mi_m0689/is_n6_v41/ai_17913640

"Vitamin [B.sub.12] deficiency is thought to be a continuum with five stages.[9] These stages include: I, normality; II, negative vitamin [B.sub.12] balance; 111, vitamin [B.sub.12] depletion with possible clinical signs and symptoms (reversible neuropsychiatric findings); IV, vitamin [B.sub.12]-deficient erythropoiesis with possible clinical signs or symptoms (potentially reversible neuropsychologic symptoms); and V, vitamin [B.sub.12] deficiency anemia with probable clinical signs and symptoms, including irreversible lateral column involvement."
http://findarticles.com/p/articles/mi_m0689/is_n6_v41/ai_17913640

http://www.postgradmed.com/issues/2001/07_01/dharmarajan.htm

Some updates & observations

Patient and other members of the family admitted that Patient was dealing with orthostatic hypotension-like episodes several years back before Patient went on any psychiatric meds. Patient said thyroid testing in the past revealed over-active thyroid.
Patient is currently suffering from memory problems and cognitive impairment.
Patient scored low in neuropsychological testing taken in the epilepsy unit of the hospital by the neuro psychology department. Doctors evaluating patient recommended a complete neurological work-up. Suspects there could be dementia symptoms. Doctors also suspected there could be an issue with the autonomic nervous system, with regard to the orthostatic hypotension. Patient's heart beat is normal, no other heart irregularities found. Some of our research on dementia indicates patients struggling with dementia-like symptoms could actually be suffering from a vitamin B-12 deficiency.

"Because the symptoms are almost identical, many health problems are often mistaken for Alzheimers and other age related dementia. But, the problems causing the symptoms are usually treatable if detected early enough. Prescription drugs interactions and side effects, vitamin B12 deficiency and dehydration most commonly produce false symptoms of dementia. (According to Consumer Reports on Health, "Any new health problem in an older person should be considered drug induced until proven otherwise.")In other words, symptoms that some people (including many doctors) often dismiss as a "normal part of aging" — really aren't. "
http://www.aging-parents-and-elder-care.com/Pages/Age_Dementia_Next_Steps.html

The following tests should be administered:

The tests may involve some or all of the following, many of which are designed to rule out other possible causes for your loved one's problems:

• An evaluation of memory and mental skills.

• A physical exam, including a review of family medical history, to detect other medical problems, including possible interactions between prescription drugs, over-the-counter medications, herbal supplements, vitamins and/or mineral supplements. Many foods can also cause unexpected interactions with prescription medications.

• A nutritional evaluation to determine if dietary problems or improper eating habits may be causing the problem.

• Blood tests, including tests for vitamin B12 and folic acid deficiencies, thyroid hormone imbalances, anemia, etc.

• EEG (electroencephalogram).

• A neurological exam to rule out other disorders of the brain such as Parkinson's disease, hydrocephalus (fluid accumulation in the brain), prior strokes and mini-strokes, brain tumors, etc.

• Brain Scan (CT or MRI).

Patient Update November 18, 2007

ORTHOSTATIC HYPOTENSION was the only condition to come out of 8 days of tests at a Henry Ford Hospital epilepsy center. We have not had a full briefing from the doctors yet. Patient is returning home tomorrow. We are looking at information regarding blood pressure and blood supply to brain now.

Note that low blood pressure is a possible Zyprexa side effect - Patient has been off Zyprexa since a week before Hospital stay.


Entry: quote from "Amalgam Illness diagnosis and treatment" by Dr. Andrew Hall Cutler PhD PE

PAGE 159
"Methyl donors and compounds involved in methlyation metabolism help the liver transport fats, help with one part of phase 2 metabolism, and have other effects in the body - most notably antidepressant effects through increased brain serotonin."

... "Methylation both increases and controls histamine levels. Your body cannot make methyl groups - it needs to get them from your diet. SAMe, choline, TMG, folate and B12 all have similar effects via methyl metabolism, and lecithin, phosphatidylcholine and phosphatidylserine can sometimes also act as methyl donors in the brain."

links

http://www.latitudes.org/forums/lofiversion/index.php?t2056.html
http://www.diagnose-me.com/cond/C376825.html
http://www.diagnose-me.com/cond/C447056.html
http://www.ebiologynews.com/1523.html
http://www.ebiologynews.com/2754.html
http://health.yahoo.com/nervous-overview/drop-attack/healthwise--hw214611.html
http://www.alternativementalhealth.com/articles/walshQZ.htm
http://www.vitaminstuff.com/vitamin-b9-folic-acid.html
http://www.vitaminstuff.com/vitamin-b9-folic-acid-2.html

http://www.drugdigest.org/DD/DVH/HerbsSideEffects/0,3925,552122%7CLecithin,00.html

Hospital Visit

Patient is undergoing a week long hospital visit in the hospital unit that specializes in the treatment and evaluation of seizures. Patient has stopped medication to return to baseline and is being monitored with medical equipment. Behavior is also being monitored as well. Current team of doctors are looking for possible causes of seizure and psychological symptoms.


Info on aspartame & seizures, psychiatric symptoms:
http://www.mpwhi.com/aspartame_and_psychiatric_disorders.htm
http://www.holisticmed.com/aspartame/adverse.txt