ENCEPHALITIS CASES

Encephalitis Cases

June

In the summer of 2000, June traveled to Hong Kong with her daughter. Before she left, she had trouble sleeping and always felt tired. But shook off the feeling, saying that she just needed more sleep. During the flight, she felt some minor cramps in her legs, but ignored them.

After she arrived on July 8, June still had trouble sleeping. She often only had two or three hours of sleep each night. Her sisters noticed that she was very forgetful, talked nonsense, acted strangely, and cried without reasons. They took her to see their family doctor, Dr. Poon. He prescribed medicine that would help her sleeping. He gave her Propanolol, Domar, Tw MNt6, Prochlorperazine Capsules, and Kphadol tab. The medicine did not help. Next night, June fell from her bed, Dr. Poon suggested she see a specialist Dr. Lee.

Her family sent her to St. Paul's Hospital. The hospital recommended Dr. Lau to see her. Dr. Lau diagnosed her with psychotic breakdown and required medication and supportive psychotherapy. During staying in the hospital, she experienced two or three seizures. Dr. Lau explained that the seizures might be triggered by the psychotic problems. Dr. Lau prescribed Serenace, Trittico, Sedapam, Sinequen, and Inderal.

Her problems did not improve. Finally on the 21st, June was allowed to leave the hospital. After leaving the hospital, she was slow, stubborn, and angry some times. Her hands were sweating a lot, and her face would turn very red-almost blue, like she could not breathe. She always woke up at midnight, and her whole body would shake. Finally on July 27th, she went to see another specialist, Dr. Hong. His prescription was Rivotril, Olanzapine, Diazepam, Diazepam, Dormain, and Trazodone.

June's condition worsened after taking Dr. Hong's medicine. She had seizures or convulsions most of time. On July 30, she was comatose and was sent to the Hong Kong Baptist Hospital. Dr. Chin, a neurology specialist, was her main treating doctor. She was febrile, had no focus sign, and plantar response absent. She was also experiencing grand mal convulsion frequently. She was kept in ICU for 16 days, and then transferred to the general ward when she was still comatose. She was diagnosed with "acute viral encephalitis" with status epileptics. EEG showed alpha-coma pattern. She was given intravenous Diantin, Epilims, Acyclovir, Fortum, Netromycin, Dompamine (Valium and Paraldehyde prn). Her seizure was largely controlled, but still was comatose. The doctor was not optimistic and worried that she might become vegetative.

Finally, on September 5, she woke up and was able to communicate with people. Before she woke up, she had involuntary leg movement, occasionally eye blanking and rolling and tongue sticking out. After she woke up, she recovered rapidly. But she had a severe short-term memory defect with a numbness on the right fingers. She still took the medications of Neurontin, Clonazepam, Melleril, and Thyroxine.

After returning to U.S., she saw Dr. Swift of the Medical College of Georgia (MCG). Dr. Swift diagnosed her as Hashimoto's encephalitis, which was induced by hypo-thyroidism. She was prescribed a heavy dose of Prednison initially. Her condition has been improved significantly. The short-term memory has come back, and she does not often complain the numbness of the fingers. Right now, June has lived a normal life. She can do daily house work. She can drive and go to market or pick up the kids at school. We are thankful that June has come back to us.

Hashimoto's encephalitis is a rare disease that is associated with hypothyroidism. It is suspected that thyroid auto antibodies in serum are raised which attacks the healthy cells and organs such as the brain. Symptoms such as delmentia, myoclonus, ataxia, and epileptic seizures were observed in the patients. Hopefully, this story can provide information for the patients of hypo or hyperthyroidism, and take proper precautions.

June
Georgia, U.S.A.

Posted: April 23, 2001

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