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Suggest Treatment For Memory Problem And Severe Movement Disorder
Question: I know this might be a little detailed, but my husband has been having a problem within the last 6-8 months now. A little background, he has Crohn's Disease (30yrs-major intestinal and bowel resection '89), diabetes, v-tach, nerve problems, ankylosing spondylopathy, herniated discs in neck and lower back, and other problems. Below is the best breakdown I can give so forgive me if it is a little lengthy but I had to put it in order.
1) Time spatial problems, i.e.:
It started one day when there were k-cups left in box—I know on a Thursday he had 1 left for Friday. He tells me that he saw 4 or 5 left. I must be gaslighting him (his words).
When he thinks an event happened last week, we have to tell him it happened either 6 months ago, maybe a year ago and he swears it was just recently even though myself and the kids can prove to him it happened a very long time ago.
Because he doesn’t believe this, I get the blame and a big argument ensues over this. He is definitely wrong but this is happening now with much more frequency.
He is using the term gaslighting now a lot more because things are happening and he thinks I am behind it, i.e. another example—we were upstairs watching TV at night before bed and he wanted to read his Kindle but couldn’t find it. He searched his area of the bedroom all over. Turned over his chair, looked inside his recliner to see if it fell into it. Not there. He went back downstairs to see if he left it there by accident. Looked all over, where he sits in the recliner—he only sits in his recliner, never anywhere else, but it was no where to be found. I went to bed my usual time around 11:15 because I had to get up at 5:15 for work. He got up during the night to make his many trips to the bathroom and he wanted to get something to eat so he went downstairs for a snack. When he went down—he saw his Kindle right in the middle of his recliner. He knows for a fact he pulled his recliner upside down looking for it earlier and he would have seen it sitting right in the middle of the seat. The next morning he told me he found it and where and alluded to the fact that I must have gotten up in the middle of the night and put it there—that I had his Kindle. I could care less about the Kindle and did not have anything to do with it. I was asleep all night. These are some of the instances now that are occurring and he is starting big fights with me about.
2) He forgets to turn off the gas to the oven--has happened a few times now to the point I have noticed.
3) He thinks he is turning the gas down on the stove and when I ask him if he wants to keep boiling the vegetables—he tells me he turned it down—I tell him he turned it up. He swears he turned it down.
4) He hears different than what comes out of my mouth, i.e.: I say I want corn for a vegetable, he hears peas. He says later on, “Oh you want peas, I say no—I want corn—okay, peas it is”.
5) He gets very belligerent now when you tell him he is wrong—way more than he used to get before.
6) Goes from 0 to over the edge in .0001 second.
7) Extremely bad temper now—way worse than before and that was bad.
8) Still breaking things and throwing food at me when he gets mad.
9) He will pick up something and put it down somewhere else, as in his keys, but with other things. However, I get the blame right out of his mouth because he thinks I touch his stuff and move it. Everything that he cannot find anymore, and I mean everything, or anything that goes wrong, i.e., biscuits not put out, or butter needed, or anything else inconsequential—the first words out of his mouth are, “Diane—what did you do with that? Or Diane, where did you put that”? in the angriest of tones. It is now wearing very thin.
The other night when I came home he was heating up slices of pork roast in a frying pan. I saw knives in the drainboard that I was putting away on the knife rack on the wall. He wanted to open a roll with the silver handled bread knife (we have several but he wanted the silver one) that he said was next to the cutting board that he had just put down. I had a wine glass I put down on the other counter so I could put my containers from lunch in the dishwasher. However, we looked all over for the silver handled bread knife and couldn’t find it. He was becoming very angry over this starting to accuse me of TOUCHING HIS STUFF and where did I put it. He eventually found it near my wine glass which in his mind meant that I had moved it and put it there. I had not seen the knife until then and had not been over to that part of the counter before then. However, it did not matter to him. He started such a big fight over this which progressed to him accusing me of all the items I had touched in our marriage and all the other things I had done wrong in our marriage and how much he hates my father (another big bone of contention with him) that eventually he wound up throwing his dinner plate at me as well as all the bills and the money envelopes for other bills in my face and on the floor.
10) He is getting very very forgetful.
11) He has no regard for the fact I have to get up early and go to work the next day. He knows I can’t sleep with the lights on in the bedroom and the TV on very very loud (hard of hearing--but he has headphones for the TV but doesn't like to use them) but when I have to go to bed, I ask him to either lower the TV or put his headphones on. He gets very mad but as soon as I get in bed he usually falls asleep in his chair, his light is still left on. I ask him to please shut his light out if he thinks he is going to fall asleep because he usually does fall asleep within 5-10 min. and he gets very indignant when I ask but it happens 9 out of 10 times. This occurs around midnight or after that the lights and TV are on.
12) He has a severe movement disorder when he sleeps. I now sleep in a separate bed. His whole body twitches which I do know comes from a lack of B-12 but I have never witnessed anything like this.
13) He has become extremely argumentative within the last month now with everyone in the family. It almost seems like he wants to pick a fight with someone.
14) When he gets in the car, he curses and yells at everyone on the road to the point I hate to get in the car with him and drive anywhere. It is not pleasant anymore.
15) Lately now, he says he will feel much better if he can just hit someone, with his fists. He has a lot of built up rage in him. Part of this comes from him getting let go from work because he got hurt at work (he did legitimately get hurt, company's fault but in New XXXXXXX insurance companies side with the employer). He was denied workmen's comp. He did get Social Security Disability which he is on now but he holds many years of resentment and lots of rage.
I don't know if this is indicative of anything in particular or could he have something going on in his brain. I would greatly appreciate if someone can help me with this.
1) Time spatial problems, i.e.:
It started one day when there were k-cups left in box—I know on a Thursday he had 1 left for Friday. He tells me that he saw 4 or 5 left. I must be gaslighting him (his words).
When he thinks an event happened last week, we have to tell him it happened either 6 months ago, maybe a year ago and he swears it was just recently even though myself and the kids can prove to him it happened a very long time ago.
Because he doesn’t believe this, I get the blame and a big argument ensues over this. He is definitely wrong but this is happening now with much more frequency.
He is using the term gaslighting now a lot more because things are happening and he thinks I am behind it, i.e. another example—we were upstairs watching TV at night before bed and he wanted to read his Kindle but couldn’t find it. He searched his area of the bedroom all over. Turned over his chair, looked inside his recliner to see if it fell into it. Not there. He went back downstairs to see if he left it there by accident. Looked all over, where he sits in the recliner—he only sits in his recliner, never anywhere else, but it was no where to be found. I went to bed my usual time around 11:15 because I had to get up at 5:15 for work. He got up during the night to make his many trips to the bathroom and he wanted to get something to eat so he went downstairs for a snack. When he went down—he saw his Kindle right in the middle of his recliner. He knows for a fact he pulled his recliner upside down looking for it earlier and he would have seen it sitting right in the middle of the seat. The next morning he told me he found it and where and alluded to the fact that I must have gotten up in the middle of the night and put it there—that I had his Kindle. I could care less about the Kindle and did not have anything to do with it. I was asleep all night. These are some of the instances now that are occurring and he is starting big fights with me about.
2) He forgets to turn off the gas to the oven--has happened a few times now to the point I have noticed.
3) He thinks he is turning the gas down on the stove and when I ask him if he wants to keep boiling the vegetables—he tells me he turned it down—I tell him he turned it up. He swears he turned it down.
4) He hears different than what comes out of my mouth, i.e.: I say I want corn for a vegetable, he hears peas. He says later on, “Oh you want peas, I say no—I want corn—okay, peas it is”.
5) He gets very belligerent now when you tell him he is wrong—way more than he used to get before.
6) Goes from 0 to over the edge in .0001 second.
7) Extremely bad temper now—way worse than before and that was bad.
8) Still breaking things and throwing food at me when he gets mad.
9) He will pick up something and put it down somewhere else, as in his keys, but with other things. However, I get the blame right out of his mouth because he thinks I touch his stuff and move it. Everything that he cannot find anymore, and I mean everything, or anything that goes wrong, i.e., biscuits not put out, or butter needed, or anything else inconsequential—the first words out of his mouth are, “Diane—what did you do with that? Or Diane, where did you put that”? in the angriest of tones. It is now wearing very thin.
The other night when I came home he was heating up slices of pork roast in a frying pan. I saw knives in the drainboard that I was putting away on the knife rack on the wall. He wanted to open a roll with the silver handled bread knife (we have several but he wanted the silver one) that he said was next to the cutting board that he had just put down. I had a wine glass I put down on the other counter so I could put my containers from lunch in the dishwasher. However, we looked all over for the silver handled bread knife and couldn’t find it. He was becoming very angry over this starting to accuse me of TOUCHING HIS STUFF and where did I put it. He eventually found it near my wine glass which in his mind meant that I had moved it and put it there. I had not seen the knife until then and had not been over to that part of the counter before then. However, it did not matter to him. He started such a big fight over this which progressed to him accusing me of all the items I had touched in our marriage and all the other things I had done wrong in our marriage and how much he hates my father (another big bone of contention with him) that eventually he wound up throwing his dinner plate at me as well as all the bills and the money envelopes for other bills in my face and on the floor.
10) He is getting very very forgetful.
11) He has no regard for the fact I have to get up early and go to work the next day. He knows I can’t sleep with the lights on in the bedroom and the TV on very very loud (hard of hearing--but he has headphones for the TV but doesn't like to use them) but when I have to go to bed, I ask him to either lower the TV or put his headphones on. He gets very mad but as soon as I get in bed he usually falls asleep in his chair, his light is still left on. I ask him to please shut his light out if he thinks he is going to fall asleep because he usually does fall asleep within 5-10 min. and he gets very indignant when I ask but it happens 9 out of 10 times. This occurs around midnight or after that the lights and TV are on.
12) He has a severe movement disorder when he sleeps. I now sleep in a separate bed. His whole body twitches which I do know comes from a lack of B-12 but I have never witnessed anything like this.
13) He has become extremely argumentative within the last month now with everyone in the family. It almost seems like he wants to pick a fight with someone.
14) When he gets in the car, he curses and yells at everyone on the road to the point I hate to get in the car with him and drive anywhere. It is not pleasant anymore.
15) Lately now, he says he will feel much better if he can just hit someone, with his fists. He has a lot of built up rage in him. Part of this comes from him getting let go from work because he got hurt at work (he did legitimately get hurt, company's fault but in New XXXXXXX insurance companies side with the employer). He was denied workmen's comp. He did get Social Security Disability which he is on now but he holds many years of resentment and lots of rage.
I don't know if this is indicative of anything in particular or could he have something going on in his brain. I would greatly appreciate if someone can help me with this.
Brief Answer:
Your husband needs to be fully evaluated
Detailed Answer:
Good morning. Thank you for your detailed accounting of things that are not right with your husband. I'm sure I don't have to tell you the obvious that your husband is suffering from a cognitive decline which is not mild as you're describing. I would guess that there is some time behind when all of these symptoms actually begin happening even though they were likely extremely mild and perhaps not even noticed by the family right away.
Having said that, if you look back at the very beginning of when things started happening and find that it has been no more than a few months at the most then, this is a rather aggressive and sounding like it's progressive type of disease. In other words, there are other things to consider aside from what most people might think is a simple onset of Alzheimer's disease. If he's had personality changes and if these symptoms have been only present for a short period of time then, he may have contracted a PRION disease and this can be quickly deteriorative needing to be diagnosed.
You haven't said anything about his having been evaluated for these symptoms but there are several things that he immediately needs to get done.
1. Full neurological and MEDICAL evaluation as well for blood chemistries, hormonal assessments for thyroid, B12, Vit. D, etc. I would also include an MHATP and FTS-Abs serological workup to rule out the presence of neurosyphilis if there is any chance at all he could've contracted an STD when he was younger which may never have been detected or treated.
2. Full neuropsychological workup.
3. MRI of the brain (possibly with gadolinium contrast depending on what the neurological evaluation reveals).
4. You mention a movement disorder during sleep so he could use a sleep study as well as an EEG recording for the purpose of detecting either some type of parasomnia (sleep disorder) or potentially seizure activity. B12 deficiency will not cause the type of twitching you're talking about though it could cause neurocognitive changes but usually not so progressive at such a young age.
I would hope that you will be able to get this type of complete and thorough workup just because he seems to be on the young side to me and yet so advanced in many ways that you really need that imaging study and some serologies to understand what's going on.
He may also require a lumbar puncture with spinal fluid analysis depending upon what the neurologist finds in his examination and/or by history.
If I've satisfactorily addressed your question then, could you do me the kindest of favors by CLOSING THIS QUERY and be sure to include some fine words of feedback and a 5 STAR rating to our transaction if you feel the response has helped you? Again, many thanks for posing your question.
Do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I would be interested in knowing how things turn out when you've seen the neurologist. And do look for someone who can get you in soon....as in within the next week or so at the latest. His behaviors seem out of control and escalating and could be dangerous to himself and even others.
This query has utilized a total of 16 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Your husband needs to be fully evaluated
Detailed Answer:
Good morning. Thank you for your detailed accounting of things that are not right with your husband. I'm sure I don't have to tell you the obvious that your husband is suffering from a cognitive decline which is not mild as you're describing. I would guess that there is some time behind when all of these symptoms actually begin happening even though they were likely extremely mild and perhaps not even noticed by the family right away.
Having said that, if you look back at the very beginning of when things started happening and find that it has been no more than a few months at the most then, this is a rather aggressive and sounding like it's progressive type of disease. In other words, there are other things to consider aside from what most people might think is a simple onset of Alzheimer's disease. If he's had personality changes and if these symptoms have been only present for a short period of time then, he may have contracted a PRION disease and this can be quickly deteriorative needing to be diagnosed.
You haven't said anything about his having been evaluated for these symptoms but there are several things that he immediately needs to get done.
1. Full neurological and MEDICAL evaluation as well for blood chemistries, hormonal assessments for thyroid, B12, Vit. D, etc. I would also include an MHATP and FTS-Abs serological workup to rule out the presence of neurosyphilis if there is any chance at all he could've contracted an STD when he was younger which may never have been detected or treated.
2. Full neuropsychological workup.
3. MRI of the brain (possibly with gadolinium contrast depending on what the neurological evaluation reveals).
4. You mention a movement disorder during sleep so he could use a sleep study as well as an EEG recording for the purpose of detecting either some type of parasomnia (sleep disorder) or potentially seizure activity. B12 deficiency will not cause the type of twitching you're talking about though it could cause neurocognitive changes but usually not so progressive at such a young age.
I would hope that you will be able to get this type of complete and thorough workup just because he seems to be on the young side to me and yet so advanced in many ways that you really need that imaging study and some serologies to understand what's going on.
He may also require a lumbar puncture with spinal fluid analysis depending upon what the neurologist finds in his examination and/or by history.
If I've satisfactorily addressed your question then, could you do me the kindest of favors by CLOSING THIS QUERY and be sure to include some fine words of feedback and a 5 STAR rating to our transaction if you feel the response has helped you? Again, many thanks for posing your question.
Do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I would be interested in knowing how things turn out when you've seen the neurologist. And do look for someone who can get you in soon....as in within the next week or so at the latest. His behaviors seem out of control and escalating and could be dangerous to himself and even others.
This query has utilized a total of 16 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr. Saghafi,
Thank you for your quick response. Let me respond to some of your questions.
He has not been evaluated for any of these symptoms yet. I cannot tell him he needs to be evaluated because if you know him like I do, he has no problems like I have described. He has said more than once that he thinks I need to see a psychiatrist, so getting him to see a neurologist would be out of the question. I will have a talk with our family physician and see if there is some way to broach the subject the next time my husband has to see our PCP. He does see him on a regular basis and I am hoping I can somehow have our PCP figure out a way to get some of this testing done on him without him knowing I have said something. As for being tested for neurosyphilis--out of the question. He was a virgin when we married and there is absolutely no way he has ever cheated. Actually, he is extremely possessive--not one of his greater qualities and another problem I have had with him but that's for another professional to handle. I do agree strongly with your assessment of the PRION disease theory which I have been trying to investigate myself, although I did not know it as PRION diseases. Through investigating on the internet and reading papers, I came up with Jakob-Creutzfeldt Disease which I now know is one of the PRION diseases. I did fail to mention he does suffer horribly from insomnia, worked in a hospital where he did have to clean instruments (he was a registered respiratory therapist for over 35 years) and was deer hunter since the age of 10. I guess all of these could be contributing factors with PRION diseases but won't know for sure until he is diagnosed and I guess the MRI would be able to show more?
Thank you for your quick response. Let me respond to some of your questions.
He has not been evaluated for any of these symptoms yet. I cannot tell him he needs to be evaluated because if you know him like I do, he has no problems like I have described. He has said more than once that he thinks I need to see a psychiatrist, so getting him to see a neurologist would be out of the question. I will have a talk with our family physician and see if there is some way to broach the subject the next time my husband has to see our PCP. He does see him on a regular basis and I am hoping I can somehow have our PCP figure out a way to get some of this testing done on him without him knowing I have said something. As for being tested for neurosyphilis--out of the question. He was a virgin when we married and there is absolutely no way he has ever cheated. Actually, he is extremely possessive--not one of his greater qualities and another problem I have had with him but that's for another professional to handle. I do agree strongly with your assessment of the PRION disease theory which I have been trying to investigate myself, although I did not know it as PRION diseases. Through investigating on the internet and reading papers, I came up with Jakob-Creutzfeldt Disease which I now know is one of the PRION diseases. I did fail to mention he does suffer horribly from insomnia, worked in a hospital where he did have to clean instruments (he was a registered respiratory therapist for over 35 years) and was deer hunter since the age of 10. I guess all of these could be contributing factors with PRION diseases but won't know for sure until he is diagnosed and I guess the MRI would be able to show more?
Brief Answer:
Neurological evaluation will be absolutely necessary for diagnosis
Detailed Answer:
Thank you for your clarifications.
As far as the recommendation that he be checked for neurosyphilis it is part of the general workup in any younger individual (50's+) with these type of very unusual and progressive behavioral and dementing symptoms. The story goes that XXXXXXX Hughes (one of the most bizarre individuals in U.S. business history) was simply considered the most eccentric and recluse person who just "didn't like people" and loving flying in his corporate 747's rather than being on the ground with irritating people. He was strongly suspected in the end to be suffering from the neurological effects of untreated syphilis which sources believe he contracted in his 20's....although he was still known to be quite strange long before neurosyphilis could've be the reason.....nevertheless.....However, I can appreciate your point of view so that suggestion could be deferred.
However, he absolutely needs neurological, neuropsychological, and imaging studies done. Chemistries would be great but for that he needs to give blood and I agree that getting him to concede that he needs help is the first major step to the rest of this process. If he does have prion disease I doubt it has been lying around dormant for this long in his system since he worked as a respiratory therapist or anything prior. This would be something he would've picked up in the past however, long it's been that he's not been acting right.
Yes, the imaging study will show very clearly changes in the brain that are referred to as a SPONGIFORM ENCEPHALOPATHY if he had a prion disease and if it were present for say at least 12 months. CJD is the most commonly contracted prion disease though the insomnia raises the possibility of Gerstmann-Straussler-Scheinker disease as opposed to CJD.
I don't know how to get your husband to the doctor other than for him to somehow recognize that the family really needs him to get checked out....if he has any passive more quiet moments that you could interject the idea of a visit...even for something as mundane as a PROSTATE or COLON checkup which all men his age should have anyways.....and perhaps that would be one way to get the ball rolling.
I wish you all the best at figuring out what's causing these problems.
Once again, your CLOSING THIS QUERY with some fine words of feedback and potentially a 5 STAR rating if you feel the responses have helped would be greatly appreciated. Again, many thanks for posing your question.
Do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I would be interested in knowing how things turn out when you've seen the neurologist. And do look for someone who can get you in soon....as in within the next week or so at the latest. His behaviors seem out of control and escalating and could be dangerous to himself and even others.
This query has utilized a total of 32 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Neurological evaluation will be absolutely necessary for diagnosis
Detailed Answer:
Thank you for your clarifications.
As far as the recommendation that he be checked for neurosyphilis it is part of the general workup in any younger individual (50's+) with these type of very unusual and progressive behavioral and dementing symptoms. The story goes that XXXXXXX Hughes (one of the most bizarre individuals in U.S. business history) was simply considered the most eccentric and recluse person who just "didn't like people" and loving flying in his corporate 747's rather than being on the ground with irritating people. He was strongly suspected in the end to be suffering from the neurological effects of untreated syphilis which sources believe he contracted in his 20's....although he was still known to be quite strange long before neurosyphilis could've be the reason.....nevertheless.....However, I can appreciate your point of view so that suggestion could be deferred.
However, he absolutely needs neurological, neuropsychological, and imaging studies done. Chemistries would be great but for that he needs to give blood and I agree that getting him to concede that he needs help is the first major step to the rest of this process. If he does have prion disease I doubt it has been lying around dormant for this long in his system since he worked as a respiratory therapist or anything prior. This would be something he would've picked up in the past however, long it's been that he's not been acting right.
Yes, the imaging study will show very clearly changes in the brain that are referred to as a SPONGIFORM ENCEPHALOPATHY if he had a prion disease and if it were present for say at least 12 months. CJD is the most commonly contracted prion disease though the insomnia raises the possibility of Gerstmann-Straussler-Scheinker disease as opposed to CJD.
I don't know how to get your husband to the doctor other than for him to somehow recognize that the family really needs him to get checked out....if he has any passive more quiet moments that you could interject the idea of a visit...even for something as mundane as a PROSTATE or COLON checkup which all men his age should have anyways.....and perhaps that would be one way to get the ball rolling.
I wish you all the best at figuring out what's causing these problems.
Once again, your CLOSING THIS QUERY with some fine words of feedback and potentially a 5 STAR rating if you feel the responses have helped would be greatly appreciated. Again, many thanks for posing your question.
Do not forget to recontact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others. I would be interested in knowing how things turn out when you've seen the neurologist. And do look for someone who can get you in soon....as in within the next week or so at the latest. His behaviors seem out of control and escalating and could be dangerous to himself and even others.
This query has utilized a total of 32 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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