ENCEPHALITIS CASES

Encephalitis Cases

Antoni

Antoni Gayá, our son, was three years old when he got sick. He turned 4 years old on July 8, 2003. We were born and live in Majorca (Balearic Island, Spain)

On March 10th he was hit on the back of the head with a ball and since that day he complained that his head hurt. The next day, they called me from his school to tell me he was complaining of having pain. We went to the Hospital and they did not see any sign of traumatism. The neurologists don't think that this incident has anything to do with the encephalitis.

The following Saturday he started to sleep and he had a fever and pharingitis. On Sunday he was still sleeping and he was very irritable and was confusing things. On Monday the doctors performed a Lumbar Puncture (LCR 90% lymphocytes) and he was diagnosed encephalitis and admitted on Intensive care at Son Dureta Hospital (Palma de Mallorca, Spain). The next day, he was anaesthetized to stop his convulsions and kept sleeping for 25 days. During this period the encephalograms showed a convulsive state. During this period he also had skin rash and a very severe edema on the face, mouth, tongue, feet and hands. He got better after increasing his injected serum albumin and with the administration of corticosteroids. When he woke-up he suffered a very severe colitis with bloody feces. His colitis was cured with the administration of corticosteroids and with the suppression of the antibiotics.

After lowering the dose of the sedatives and anesthetics he suffered myclonic seizures for 5 days. The myclonic seizures started in his left foot and went-up to his left leg and left arm with flexion of the hand outward and that often were generalized. During these 5 days the myclonic seizures were 2 minutes long every 4 minutes. He was taking Keppra (350mg/ 24h) and Fenitoina. His treatment was switched to Clonacepam instead of Fenitoina and was better.

After we moved to San Juan de Dios Hospital in Barcelona, his condition was better regarding his convulsions. The doctors stopped the Clonacepam treatment as he was moving his head a lot (from right to left and up and down) and he was also moving his mouth as if he wanted to talk. After the suppression of Clonacepam treatment the bucal movement disappear and he had less head movements. He started a treatment with Tegretol but he started to have convulsions and the treatment was suspended after four days. During this time he was disconnected. We could only make him smile during 2 days but we felt that he was not looking at us. His eyes were usually looking to the right (His right brain hemisphere is severely damaged). He did not like to be touched and did not accept any contact. He was crying a lot, a lot of times as if he was feeling a lot of pain, others as if he was in panic. Slowly, I finally calmed him in my arms. It seemed as if my voice was calming him. All of a sudden he turned his eyes to the left (NMR also showed damage to the left side of the brain) and this was correlated with the initiation of treatment with Lamictal at a very low doses. Then he had again myclonic seizures similar to the ones he had before but exactly at the other side. Slowly he stopped crying and was very disconnected during 5 days. He did not reacted to any stimuli. He was not responding to a needle, he was not moving and had a lot of saliva (he was not swallowing).

All the sudden on the June 17th he started to smile and to look at us, he seemed a happy kid. Since then we feel he is improving. He can follow objects with his eyes (although not always). He can watch TV for a few seconds. He smiles a lot. He has a better muscular tone. He is starting to hold his head better. He likes the exercises that we do with a ball where he pushes with his legs and he can almost stand-up. He moves his legs and arms with force. He makes guttural sounds. Sometimes, we think that he is calling us: ehhhhh, ahhhhh. He hears the sounds very well, he likes music and it relaxes him. He smiles when we go for a walk. He has tickles. He can feel pain. He is more connected to the environment but cannot make any voluntary movement. We think he is starting to roll over in his bed, but we are not sure. He has head movements very often and that makes it very difficult to concentrate on anything and makes him to be in a bad mood. He gets fed with a gastric valve (a G-tube). If we give him water with a spoon he can swallow but he gets upset. We have tried to give him chocolate or other things that he liked but it seems that the feeling of the flavors bother him.

We don't know what to do. Our neurologist has sent us to the rehabilitation unit of the Hospital where they only do conventional physiotherapy. We are also taking him to another center where they do Vojta therapy. In our home we do the little bit that we had learned about stimulation (Bobath). We need help to know what is the best way that we have to follow for our son to get better. We are willing to do absolutely whatever is necessary for our son.

Natalia Martinez & Jesús Gayá
Majorca, Spain

Posted: July 21, 2003

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