My father, age 70, was having flu like symptoms on Sept. 25, 2001 while visiting his grandchildren on vacation in South Carolina. Mother brought him home to West Virginia on the 26th. His primary care Doctor thought he had a prostate infection and gave him oral antibiotics. That night mother said he got out of bed and brushed his teeth twice, shaved, did a few other weird things and went back to bed. Dad fell out of bed twice and mother had to help drag him back in bed. He woke up early and while dressing himself he passed out and hit his head on a nightstand. 911 (emergency) and some neighbors got my father to a rural hospital. They were baffled.
My sister arrived from South Carolina to help at 10PM and she and mom had to physically restrain him to keep dad's IVs in. He rolled and thrashed around in bed all night. My other sister who is an RN, and I (his son) arrived at 7 AM after driving all night. We relieved my mother and other sister. We experienced the same rolling and thrashing in bed for the next day and into the night. He eventually calmed down some and we were able to feed him. Actually he was able to shave himself with an electric razor and even feed himself. His eyes seemed to not be focusing. He could identify each of his children. He could sit on the end of the bed and stand up with our assistance. He was able to take a few baby steps and move to a chair beside his bed. He would stare at a newspaper and seemed to be reading it. We asked him what time it was and he could look at the wall clock and tell us. His speech wasn't easy or normal and it took considerable effort.
The following day he rested better, although he only slept about 1 hour total. We slept zero. It took one of us on each side of his bed to keep him from getting out of bed and pulling out his catheter and IV. During one of his spells of sitting in the chair and looking at a newspaper he told us that his College team had won and told us the score. So he was obviously reading. Then he laid the paper down and went to sleep.
After four days of antibiotics we decided that this wasn't the correct treatment and I had him transported to a Nuero ICU in Augusta Ga. An MRI there showed an abnormal front temporal lobe.
Diagnosis: Herpes Simplex Encephalitis
Treatment: Acyclovir. For the first two weeks we hired sitters to stay with mom and dad, day and night for assistance, when we couldn't be there. The retirement community provides three meals a day, has an indoor swimming pool, bingo, social activities, a library, etc. Dad has progressed to the point that sitters are no longer needed. He no longer needs a wheel chair. We do use it as an extra chair around the table, and take it with us for doctor visits if he has to walk long distances. He still has no awareness of where he is. We have photos of family members with names all over their apartment. He is starting to sleep better. Dad gets up two or three times a night for bathroom. He can still do simple math problems faster than most people can operate a calculator. From the dark days back in September & October he has come a long way. He's pleasant to be around, I've taken him in to the pool numerous times to get exercise. He also rides the stationary bike in the exercise room. He has reduced from 225 to 192lbs. Looks physically great. He walks up a flight of stairs (20 steps) several times a day. Plays a very good game of pool (billiards). Its amazing that he can't remember his room number but thinks several shots ahead while playing pool to line up the cue ball. I despise this disease. During a follow-up visit with the neurologist I suggested another MRI for comparison with the ones taken while he was in the ICU. The neurologist agreed but wasn't sure what we would see. No change, partial improvement, or completely normal MRI. He said it would be a learning experience for everyone since this disease is so odd. To everyone's surprise the MRI showed an increase in the affected area? Although Dad seems to be slowly improving. Why would the affected area now be larger than before? The neurologist suggested an arteriogram to look at blood flow, he had always been suspicious of a possible vascular problem but he was reluctant to perform an arteriogram while Dad was in the ICU. He didn't want to complicate Dads condition by sedating him and injecting dye. After Dad seemed to respond to the 21 days of Acyclovir the neurologist had concluded that maybe it wasn't vascular, now he's not so sure. After the arteriogram we are taking him to Duke. The neurologist suggested a new set of Doctors to review the case. Tommy
South Carolina, U.S.A.
Posted: March 07, 2002